Provider Demographics
NPI:1336549948
Name:BARTZ, PAMELA D
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:BARTZ
Suffix:
Gender:F
Credentials:
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 1385
Mailing Address - Street 2:
Mailing Address - City:ZILLAH
Mailing Address - State:WA
Mailing Address - Zip Code:98953-1385
Mailing Address - Country:US
Mailing Address - Phone:509-969-8623
Mailing Address - Fax:
Practice Address - Street 1:900 MAPLE WAY
Practice Address - Street 2:
Practice Address - City:ZILLAH
Practice Address - State:WA
Practice Address - Zip Code:98953-9416
Practice Address - Country:US
Practice Address - Phone:509-829-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant