Provider Demographics
NPI:1922690528
Name:CARTER, PAMELA J (RDH, IPDH)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:CARTER
Suffix:
Gender:F
Credentials:RDH, IPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LITTLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:ME
Mailing Address - Zip Code:04444-5142
Mailing Address - Country:US
Mailing Address - Phone:207-478-2125
Mailing Address - Fax:
Practice Address - Street 1:60 MAIN RD N STE D
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1344
Practice Address - Country:US
Practice Address - Phone:207-478-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2895124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist