Provider Demographics
NPI:1669609251
Name:DAVIS, PAMELA BECK (DDS)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:BECK
Last Name:DAVIS
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 1:2903 ASPEN DRIVE
Mailing Address - Street 2:UNIT #G
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538
Mailing Address - Country:US
Mailing Address - Phone:970-667-6040
Mailing Address - Fax:970-667-6069
Practice Address - Street 1:10135 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4003
Practice Address - Country:US
Practice Address - Phone:303-431-5830
Practice Address - Fax:303-431-1324
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9937122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1669609251Medicaid