Provider Demographics
NPI:1982833786
Name:HARTMAN, AMANDA (DDS)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1583 E COMMON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3174
Mailing Address - Country:US
Mailing Address - Phone:830-629-1954
Mailing Address - Fax:
Practice Address - Street 1:1583 E COMMON ST STE 202
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3174
Practice Address - Country:US
Practice Address - Phone:830-629-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248261223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice