Healthcare Provider Details

I. General information

NPI: 1992037451
Provider Name (Legal Business Name): PAMELA J AMES IPDH, RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 04/18/2024
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 MAIN ST N
SEARSMONT ME
04973-3404
US

IV. Provider business mailing address

207 MAIN ST N
SEARSMONT ME
04973-3404
US

V. Phone/Fax

Practice location:
  • Phone: 207-930-9020
  • Fax:
Mailing address:
  • Phone: 207-930-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberIPH23
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH2889
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: