Healthcare Provider Details
I. General information
NPI: 1861696932
Provider Name (Legal Business Name): AMANDA KUHN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/13/2007
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 COLONY CROSSING PL
MIDLOTHIAN VA
23112-4281
US
IV. Provider business mailing address
2400 COLONY CROSSING PL
MIDLOTHIAN VA
23112-4281
US
V. Phone/Fax
- Phone: 804-639-6445
- Fax: 804-639-6400
- Phone: 804-639-6445
- Fax: 804-639-6400
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | 0401411501 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: