Provider Demographics
NPI:1154690378
Name:AMDENT LTD
Entity Type:Organization
Organization Name:AMDENT LTD
Other - Org Name:AMERICAN DENTAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-372-6693
Mailing Address - Street 1:1301 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2140
Mailing Address - Country:US
Mailing Address - Phone:610-372-6313
Mailing Address - Fax:
Practice Address - Street 1:1030 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9328
Practice Address - Country:US
Practice Address - Phone:717-627-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty