Provider Demographics
NPI:1942296819
Name:AMRHEIN, EDWARD SULLIVAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SULLIVAN
Last Name:AMRHEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 HYDRAULIC RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8124
Mailing Address - Country:US
Mailing Address - Phone:434-977-3348
Mailing Address - Fax:
Practice Address - Street 1:244 HYDRAULIC RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8124
Practice Address - Country:US
Practice Address - Phone:434-977-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04380000881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery