Doctor Name: | DR. AMY TREESE LIGHT |
NPI Number: | 1063507010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DMD |
License Number: | 9152 |
Business Practice Address: | 9812 Falls Rd Suite 118 Potomac, MD - 208543976 |
Business Phone Number: | 3019839804 |
Business Fax Number: | 3019835571 |
Mailing Address: | 9812 Falls Rd, Suite 118 POTOMAC |
State: | MD |
Postal Code: | 208543976 |
Phone Number: | 3019839804 |
Fax Number: | 3019835571 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 9152 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MD |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |