Provider Demographics
NPI:1710048251
Name:MOTWANI, AMIT CHANDRAKUMAR (DMD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:CHANDRAKUMAR
Last Name:MOTWANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 EASTON RD
Mailing Address - Street 2:STE 9
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1818
Mailing Address - Country:US
Mailing Address - Phone:215-491-4711
Mailing Address - Fax:215-491-4407
Practice Address - Street 1:1380 EASTON RD
Practice Address - Street 2:STE 9
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1818
Practice Address - Country:US
Practice Address - Phone:215-491-4711
Practice Address - Fax:215-491-4407
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030814L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice