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General NPI Number Information
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NPI Number | 1609648088
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Entity Type | Individual
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Provider Name | JASKIRTH PAMMA DDS
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Gender | Female
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 1095 WINTON WAY
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City | ATWATER
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State | CA
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Zip | 95301-3502
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Country | US
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Telephone | 200-358-5485
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Fax |
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Provider Business Mailing Address
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Address Line | 1523 FIELDCREST CT
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City | ATWATER
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State | CA
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Zip | 95301-4070
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Country | US
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Telephone | 209-756-0549
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 109179
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License Number State | CA
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