Provider Demographics
NPI:1750348249
Name:EVANS, PAMELA JOY (DDS)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:JOY
Last Name:EVANS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:JOY
Other - Last Name:ANDREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6600 FRANCE AVE S
Mailing Address - Street 2:SUITE 415
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1805
Mailing Address - Country:US
Mailing Address - Phone:952-224-9771
Mailing Address - Fax:952-224-9790
Practice Address - Street 1:5401 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2443
Practice Address - Country:US
Practice Address - Phone:612-827-2801
Practice Address - Fax:612-827-7097
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND9777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist