Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1336549948 |
---|---|
Provider Name | Pamela D Bartz |
First Address | Zillah, WA 98953-1385 |
Second Address | Zillah, WA 98953-9416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2014 |
Last Update Date | 02/09/2014 |