Provider Demographics
NPI:1750398814
Name:JULIEN-COMITO, PAMELA CLAIRE (RDH)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:CLAIRE
Last Name:JULIEN-COMITO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:CLAIRE
Other - Last Name:JULIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 LINDA LANE
Mailing Address - Street 2:
Mailing Address - City:NAHANT
Mailing Address - State:MA
Mailing Address - Zip Code:01908-1008
Mailing Address - Country:US
Mailing Address - Phone:781-598-8770
Mailing Address - Fax:
Practice Address - Street 1:10 KIRTLAND ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905
Practice Address - Country:US
Practice Address - Phone:781-595-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13131124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist