Individual
MRS. AMANDA DIXON CERQUEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, PA
Contact information
Practice address
1328 N. LAKE BLVD, SUITE 107, CAROLINA BEACH, NC 28428
(910) 458-3232
(910) 458-3241
Mailing address
1328 N. LAKE BLVD, SUITE 107, CAROLINA BEACH, NC 28428
(910) 458-3232
(910) 458-3241
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7597
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902229
—
NC
Enumeration date
10/03/2006
Last updated
07/08/2007
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