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General NPI Number Information
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NPI Number | 1588827257
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Entity Type | Individual
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Provider Name | PAMELA ROUSE DDS
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Gender | Female
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 5918 NC 39 HWY SOUTH
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City | BUNN
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State | NC
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Zip | 27508
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Country | US
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Telephone | 919-496-8070
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40881
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City | RALEIGH
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State | NC
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Zip | 27629-0881
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Country | US
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Telephone |
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 6172
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License Number State | NC
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