Individual
AMANDA MONTALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
401 W ALLEGHENY AVE, PHILADELPHIA, PA 19133-3644
(215) 291-2500
Mailing address
1412-22 FAIRMOUNT AVENUE, PHILADELPHIA, PA 19130-2908
(215) 235-4573
(215) 232-4093
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041894
PA
Other
Enumeration date
07/28/2018
Last updated
09/02/2021
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