| NPI | 1720092133 |
|---|---|
| Former Name | PAMELA SUE CERMAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 8732) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 018573) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2019-03-13 |