Provider Demographics
NPI:1922528157
Name:SEHRA, PAMELA (DDS, MPH, FAGD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:SEHRA
Suffix:
Gender:F
Credentials:DDS, MPH, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 POSTAL PKWY
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-2979
Mailing Address - Country:US
Mailing Address - Phone:770-254-9332
Mailing Address - Fax:
Practice Address - Street 1:71 POSTAL PKWY
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2979
Practice Address - Country:US
Practice Address - Phone:830-469-6805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001627-15122300000X
GADN122227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist