Provider Demographics
NPI:1811100894
Name:AMORES, EVANGELINE LACORTE (DDS)
Entity type:Individual
Prefix:DR
First Name:EVANGELINE
Middle Name:LACORTE
Last Name:AMORES
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 1:490 POST ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1401
Mailing Address - Country:US
Mailing Address - Phone:415-277-7220
Mailing Address - Fax:415-277-7227
Practice Address - Street 1:490 POST ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1401
Practice Address - Country:US
Practice Address - Phone:415-277-7220
Practice Address - Fax:415-277-7227
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0458091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice