Provider Demographics
NPI:1972635647
Name:PUTMAN, PAMELA SUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:SUE
Last Name:PUTMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8219
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28814-8219
Mailing Address - Country:US
Mailing Address - Phone:828-645-3797
Mailing Address - Fax:828-645-2948
Practice Address - Street 1:200 NEWSTOCK RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-8749
Practice Address - Country:US
Practice Address - Phone:828-645-3797
Practice Address - Fax:828-645-2948
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16821122300000X
NC9052122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist