Healthcare Provider Details

I. General information

NPI: 1235340126
Provider Name (Legal Business Name): AMHERST ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 OVERLOOK DR SUITE 6
AMHERST NH
03031-2831
US

IV. Provider business mailing address

5 OVERLOOK DR SUITE 6
AMHERST NH
03031-2831
US

V. Phone/Fax

Practice location:
  • Phone: 603-672-0844
  • Fax: 603-672-5972
Mailing address:
  • Phone: 603-672-0844
  • Fax: 603-672-5972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateNH

VIII. Authorized Official

Name: DR. EVEN DIANE SHIEH
Title or Position: DOCTOR, OWNER
Credential: DMD, MMSC
Phone: 603-672-0844