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General NPI Number Information
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NPI Number | 1851225346
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Entity Type | Individual
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Provider Name | AMY MARIE DE SANTIS COA
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Gender | Female
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 1615 N HARRISON AVE STE 20
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City | PIERRE
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State | SD
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Zip | 57501-2392
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Country | US
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Telephone | 605-945-1710
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Fax | 605-494-0467
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Provider Business Mailing Address
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Address Line | 113 COMANCHE RD
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City | FORT MEADE
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State | SD
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Zip | 57741-1002
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Country | US
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Telephone | 605-347-2511
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Fax | 612-725-1239
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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 | 156FX1101X
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Taxonomy Name | Ophthalmic Assistant
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License Number | 213342
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License Number State | SD
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