Provider Demographics
NPI:1255663043
Name:AMERI, SANDRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:AMERI
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 1:1001 MARINA DR
Mailing Address - Street 2:APT 711
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1535
Mailing Address - Country:US
Mailing Address - Phone:201-478-0686
Mailing Address - Fax:
Practice Address - Street 1:100 AMESBURY ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1321
Practice Address - Country:US
Practice Address - Phone:978-686-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist