MEDICARE: AMY C SENH DDS LTD

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	060.010815	IL
2	302R00000X	Health Maintenance Organization	019026488	IL

General Provider Information

NPI Number	:	1609152131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMY C SENH DDS LTD

Provider Business Mailing Address
First Line	:	2917 17TH STREET
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201
Country	:	US
Telephone Number	:	309-788-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	2917 17TH STREET
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201
Country	:	US
Telephone Number	:	309-788-6001
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. AMY C SENH
Credential	:	D.D.S
Telephone Number	:	309-788-6001

Provider Enumeration Date	:	10/28/2011
Last Update Date	:	06/29/2012

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