Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | CA |
NPI | 1093957367 |
---|---|
Provider Name | Ms. Pamela Hawara |
First Address | Canyon Country, CA 91387-4701 |
Second Address | North Hills, CA 91343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 01/04/2009 |