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NPI Code Detail

MEDICARE: AMANDA LAW DMD

MEDICARE: AMANDA LAW 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
1390200000XStudent in an Organized Health Care Education/Training ProgramMA

General Provider Information

NPI Number : 1972449601
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LAW DMD
Provider Business Mailing Address
First Line : 13579 CRYSTAL RIVER DR
Second Line :
City : ORLANDO
State : FL
Zip : 32828-8444
Country : US
Telephone Number : 407-459-0347
Fax Number :
Provider Business Practice Location Address
First Line : 30 WARREN ST
Second Line :
City : BRIGHTON
State : MA
Zip : 02135-3602
Country : US
Telephone Number : 617-254-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 04/27/2026

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Directions to “ AMANDA LAW DMD” Practice Location

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