MEDICARE: AMANDA SPRINGER DDS PLLC

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	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770293706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA SPRINGER DDS PLLC

Provider Business Mailing Address
First Line	:	5376 BIG TYLER RD
Second Line	:
City	:	CROSS LANES
State	:	WV
Zip	:	25313-1059
Country	:	US
Telephone Number	:	304-776-2223
Fax Number	:	304-776-2223

Provider Business Practice Location Address
First Line	:	5376 BIG TYLER RD
Second Line	:
City	:	CROSS LANES
State	:	WV
Zip	:	25313-1059
Country	:	US
Telephone Number	:	304-776-2223
Fax Number	:	304-776-2223

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	AMANDA SPRINGER
Credential	:	DDS
Telephone Number	:	304-776-2223

Provider Enumeration Date	:	11/30/2022
Last Update Date	:	11/30/2022

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