# THEODORE AMEREDES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053373092
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS036716 | PA | Yes |

## Other

- **Enumeration date:** 04/05/2006
- **Last updated:** 02/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1015259710001 | — | PA |
| 05 | — | 1015259710002 | — | PA |
| 05 | — | 1015259710003 | — | PA |
| 05 | — | 1015259710004 | — | PA |
| 05 | — | 1015259710005 | — | PA |
| 05 | — | 1015259710006 | — | PA |
| 05 | — | 1015259710007 | — | PA |
| 05 | — | 1015259710008 | — | PA |
| 05 | — | 1015259710009 | — | PA |
| 05 | — | 1015259710010 | — | PA |
| 05 | — | 1015259710011 | — | PA |
| 05 | — | 1015259710012 | — | PA |
| 05 | — | 1015259710013 | — | PA |