Individual
DR. AMANDA PAIGE STATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1015 N MAIN ST, SUMMERVILLE, SC 29483-6706
(843) 486-3144
Mailing address
8344 BENT OAK DR, INDIANAPOLIS, IN 46236-6369
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10401
SC
122300000X
Dentist
12013783A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2022
Last updated
02/13/2023
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