Provider Demographics
NPI:1467509240
Name:CRYAN, AMANDA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:M
Last Name:CRYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6501 TRANSIT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1427
Mailing Address - Country:US
Mailing Address - Phone:716-580-3580
Mailing Address - Fax:716-580-3580
Practice Address - Street 1:6501 TRANSIT RD
Practice Address - Street 2:SUITE B
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1427
Practice Address - Country:US
Practice Address - Phone:716-580-3580
Practice Address - Fax:716-580-3580
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0520081223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02847652Medicaid