# AMANDA CERQUEIRA, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922284470
- **Authorized official:** MR. JOSE DANIEL CERQUEIRA (OFFICE MANAGER)
- **Authorized official phone:** (910) 458-3232

## Contact information

- **Practice address:** 1328 N LAKE PARK BLVD, STE. 107, CAROLINA BEACH, NC 28428-3935
- **Practice address phone:** (910) 458-3232
- **Practice address fax:** (910) 458-3253
- **Mailing address:** 1328 N LAKE PARK BLVD, STE. 107, CAROLINA BEACH, NC 28428-3935
- **Mailing address phone:** (910) 458-3232
- **Mailing address fax:** (910) 458-3253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7597 | NC | Yes |

## Other

- **Enumeration date:** 01/15/2008
- **Last updated:** 01/15/2008