Provider Demographics
NPI:1487036737
Name:DEL CUETO, AMANDA N (DMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:DEL CUETO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:DEL CUETO
Other - Last Name:DILLINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3500 E FLETCHER AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4712
Mailing Address - Country:US
Mailing Address - Phone:813-972-3500
Mailing Address - Fax:
Practice Address - Street 1:3500 E FLETCHER AVE STE 221
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4712
Practice Address - Country:US
Practice Address - Phone:813-734-7102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21346122300000X
FLDN 213461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist