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General NPI Number Information
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NPI Number | 1679804595
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Entity Type | Individual
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Provider Name | PAMELA ANN WITTMEYER RDH
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Gender | Female
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 01/15/2010
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Provider Practice Location Address
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Address Line | 800 HAINES
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City | LIBERTY
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State | MO
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Zip | 64068-1006
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Country | US
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Telephone | 816-595-4306
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Fax |
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Provider Business Mailing Address
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Address Line | 20500 GRASS PAD RD
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City | PLATTE CITY
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State | MO
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Zip | 64079-8295
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Country | US
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Telephone | 816-804-0855
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 001786
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License Number State | MO
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