Provider Demographics
NPI:1043375454
Name:SENH, AMY C (DDS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:SENH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5382
Mailing Address - Country:US
Mailing Address - Phone:309-788-6001
Mailing Address - Fax:309-788-6450
Practice Address - Street 1:2917 17TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5382
Practice Address - Country:US
Practice Address - Phone:309-788-6001
Practice Address - Fax:309-788-6450
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice