Provider Demographics
NPI:1114430451
Name:AMANDA LEE DDS PA
Entity Type:Organization
Organization Name:AMANDA LEE DDS PA
Other - Org Name:HILLSBOROUGH PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SEIDL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-360-8755
Mailing Address - Street 1:310 MILLSTONE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278
Mailing Address - Country:US
Mailing Address - Phone:919-360-8755
Mailing Address - Fax:919-296-1016
Practice Address - Street 1:310 MILLSTONE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278
Practice Address - Country:US
Practice Address - Phone:919-360-8755
Practice Address - Fax:919-296-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty