Provider Demographics
NPI:1992037451
Name:SARGENT, PAMELA J (IPDH)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:SARGENT
Suffix:
Gender:F
Credentials:IPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:SEARSMONT
Mailing Address - State:ME
Mailing Address - Zip Code:04973-3404
Mailing Address - Country:US
Mailing Address - Phone:207-930-0047
Mailing Address - Fax:
Practice Address - Street 1:207 MAIN ST N
Practice Address - Street 2:
Practice Address - City:SEARSMONT
Practice Address - State:ME
Practice Address - Zip Code:04973-3404
Practice Address - Country:US
Practice Address - Phone:207-930-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEIPH23124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist