MEDICARE: AMIT CHANDRAKUMAR MOTWANI DMD

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	DS030814L	PA

General Provider Information

NPI Number	:	1710048251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIT CHANDRAKUMAR MOTWANI DMD

Provider Business Mailing Address
First Line	:	1380 EASTON RD
Second Line	:	STE 9
City	:	WARRINGTON
State	:	PA
Zip	:	18976-1818
Country	:	US
Telephone Number	:	215-491-4711
Fax Number	:	215-491-4407

Provider Business Practice Location Address
First Line	:	1380 EASTON RD
Second Line	:	STE 9
City	:	WARRINGTON
State	:	PA
Zip	:	18976-1818
Country	:	US
Telephone Number	:	215-491-4711
Fax Number	:	215-491-4407

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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