Provider Demographics
NPI:1649610148
Name:DENTON, AMANDA JEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JEAN
Last Name:DENTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1422 ELBRIDGE PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8551
Mailing Address - Country:US
Mailing Address - Phone:314-753-8154
Mailing Address - Fax:
Practice Address - Street 1:2440 N JOSEY LN STE 201
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1698
Practice Address - Country:US
Practice Address - Phone:512-252-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist