Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN1858986 | MA |
NPI | 1104487743 |
---|---|
Provider Name | Dr. Morgane Chloe Amat |
First Address | Lynn, MA 01902-5003 |
Second Address | Lynn, MA 01902-5003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2019 |
Last Update Date | 19/07/2021 |