MEDICARE: JOHN M AMOROSO 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	122300000X	Dentist	DS17606L	PA

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
2	105376	OTHER	PA	BLUE SHIELD

General Provider Information

NPI Number	:	1780692731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M AMOROSO DMD

Provider Business Mailing Address
First Line	:	627 MAIN ST
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666
Country	:	US
Telephone Number	:	724-547-7116
Fax Number	:	724-547-4260

Provider Business Practice Location Address
First Line	:	627 MAIN ST
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-1834
Country	:	US
Telephone Number	:	724-547-7116
Fax Number	:	724-547-4260

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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