| Amdent Ltd. | |
|
1425 Penn Ave Wyomissing PA 19610-2133 | |
| (610) 372-6693 | |
| (610) 372-4178 |
| Full Name | Amdent Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 1425 Penn Ave, Wyomissing, Pennsylvania |
| Authorized Official Name and Position | Shannon Peters (OPERATIONS MANAGER) |
| Authorized Official Contact | 6103726693 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amdent Ltd. 1301 Penn Ave Wyomissing PA 19610-2140 Ph: (610) 372-6313 | Amdent Ltd. 1425 Penn Ave Wyomissing PA 19610-2133 Ph: (610) 372-6693 |
| NPI Number | 1386673432 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 01/09/2012 |
| Medicare PECOS PAC ID | 1951733021 |
|---|---|
| Medicare Enrollment ID | O20191111001253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386673432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Jordan Fried |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1932487675 PECOS PAC ID: 1153684261 Enrollment ID: I20180423003006 |
| Provider Name | Steven A Fontana |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1427336304 PECOS PAC ID: 0244561744 Enrollment ID: I20191015001857 |
| Provider Name | Kyung H Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1679954432 PECOS PAC ID: 9739487315 Enrollment ID: I20191126001118 |
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