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General NPI Number Information
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NPI Number | 1114430451
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Entity Type | Organization
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Legal Business Name | AMANDA LEE DDS PA
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 310 MILLSTONE DR SUITE 1
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City | HILLSBOROUGH
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State | NC
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Zip | 27278
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Country | US
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Telephone | 919-360-8755
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Fax | 919-296-1016
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Provider Business Mailing Address
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Address Line | 310 MILLSTONE DR SUITE 1
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City | HILLSBOROUGH
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State | NC
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Zip | 27278
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Country | US
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Telephone | 919-360-8755
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Fax | 919-296-1016
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. AMANDA LEE SEIDL
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Credential | DDS
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Telephone | 919-360-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 8957
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License Number State | NC
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