Individual
MR. PRADYUMN N AMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
250 WEST SIDE MALL, SUITE 221 OFFICE BLDG, KINGSTON, PA 18704
(570) 288-8456
Mailing address
250 WEST SIDE MALL, SUITE 221 OFFICE BLDG, KINGSTON, PA 18704
(570) 288-8456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS020941L
PA
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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