MEDICARE: DR. NANCY AMOIA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	045209	NY

General Provider Information

NPI Number	:	1275756694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY AMOIA D.D.S.

Provider Business Mailing Address
First Line	:	2391 BELL BLVD
Second Line	:	BAYSIDE DENTAL ASSOCIATES
City	:	BAYSIDE
State	:	NY
Zip	:	11360-2019
Country	:	US
Telephone Number	:	718-631-7337
Fax Number	:	718-428-0431

Provider Business Practice Location Address
First Line	:	2391 BELL BLVD
Second Line	:	BAYSIDE DENTAL ASSOCIATES
City	:	BAYSIDE
State	:	NY
Zip	:	11360-2019
Country	:	US
Telephone Number	:	718-631-7337
Fax Number	:	718-428-0431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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