Basic Information
| Provider Information | |||||||||
| NPI: | 1174549422 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAMELA A. LINKER, DDS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5500 HIGHWAY 49 S STE 100 | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280758456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044552177 | ||||||||
| FaxNumber: | 7044553816 | ||||||||
| Practice Location | |||||||||
| Address1: | 5500 HIGHWAY 49 S STE 100 | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280758456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044552177 | ||||||||
| FaxNumber: | 7044553816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 09/13/2007 | ||||||||
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| AuthorizedOfficialLastName: | LAWS | ||||||||
| AuthorizedOfficialFirstName: | GLENDA | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7044552177 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 5226 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 8995306 | 05 | NC | MEDICAID |