Provider Demographics
NPI:1811993165
Name:AMANN, NATALIE ANN (DDSMAGD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ANN
Last Name:AMANN
Suffix:
Gender:F
Credentials:DDSMAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 S MENNONITE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2814
Mailing Address - Country:US
Mailing Address - Phone:610-265-3939
Mailing Address - Fax:610-265-8461
Practice Address - Street 1:491 ALLENDALE RD
Practice Address - Street 2:STE 203
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1431
Practice Address - Country:US
Practice Address - Phone:610-265-3939
Practice Address - Fax:610-265-8461
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS244771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA590693OtherBLUE CROSS PROVIDER #