Provider Demographics
NPI:1932286812
Name:WERDLOW, PAMELA ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ELIZABETH
Last Name:WERDLOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27839 SAN JOSE COURT
Mailing Address - Street 2:
Mailing Address - City:LUTHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076
Mailing Address - Country:US
Mailing Address - Phone:248-474-0600
Mailing Address - Fax:248-473-4180
Practice Address - Street 1:25296 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1760
Practice Address - Country:US
Practice Address - Phone:248-423-9393
Practice Address - Fax:484-237-8932
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist