Individual
THEODORE AMEREDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1433 OVERLOOK DR, WEIRTON, WV 26062-5126
(412) 680-0366
Mailing address
1433 OVERLOOK DR, WEIRTON, WV 26062-5126
(412) 680-0366
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS036716
PA
Other
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
Enumeration date
04/05/2006
Last updated
02/14/2011
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