Provider Demographics
NPI:1174509111
Name:SKARBEK, AMANDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:SKARBEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 HERMIT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2722
Mailing Address - Country:US
Mailing Address - Phone:215-680-3677
Mailing Address - Fax:
Practice Address - Street 1:2701 COWPATH RD # ROD
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-2300
Practice Address - Country:US
Practice Address - Phone:215-368-7025
Practice Address - Fax:215-368-7026
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036256122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist