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General NPI Number Information
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NPI Number | 1063201713
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Entity Type | Individual
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Provider Name | AMANDA SITHA GROSS DMD
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Gender | Female
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 1 ROBERT WOOD JOHNSON PL
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1928
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Country | US
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Telephone | 732-937-8652
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Fax |
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Provider Business Mailing Address
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Address Line | 6 TRACI LN
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City | EDISON
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State | NJ
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Zip | 08817-2222
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Country | US
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Telephone | 732-208-7761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | -
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License Number State | NJ
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