Provider Demographics
NPI:1912120296
Name:PAMELA J. SKAFF DDS
Entity Type:Organization
Organization Name:PAMELA J. SKAFF DDS
Other - Org Name:DENTAL DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SKAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:904-280-2884
Mailing Address - Street 1:200 SOLANA RD
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2232
Mailing Address - Country:US
Mailing Address - Phone:904-280-2884
Mailing Address - Fax:904-280-2886
Practice Address - Street 1:200 SOLANA RD
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-2232
Practice Address - Country:US
Practice Address - Phone:904-280-2884
Practice Address - Fax:904-280-2886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN106361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty