Healthcare Provider Details

I. General information

NPI: 1972635647
Provider Name (Legal Business Name): PAMELA SUE PUTMAN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NEWSTOCK RD
ASHEVILLE NC
28804-8749
US

IV. Provider business mailing address

PO BOX 8219
ASHEVILLE NC
28814-8219
US

V. Phone/Fax

Practice location:
  • Phone: 828-645-3797
  • Fax: 828-645-2948
Mailing address:
  • Phone: 828-645-3797
  • Fax: 828-645-2948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN16821
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9052
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: