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General NPI Number Information
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NPI Number | 1467130658
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Entity Type | Individual
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Provider Name | PAMELA KOWALIK DMD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 2265 W HILLSBORO BLVD STE C
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1114
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Country | US
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Telephone | 954-427-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 2265 W HILLSBORO BLVD STE C
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1114
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Country | US
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Telephone | 773-659-9794
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN28369
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License Number State | FL
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