Provider Demographics
NPI:1861410862
Name:AMOROSI, PETER CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:CRAIG
Last Name:AMOROSI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-2659
Mailing Address - Country:US
Mailing Address - Phone:508-394-9007
Mailing Address - Fax:
Practice Address - Street 1:1292 ROUTE 28
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-4452
Practice Address - Country:US
Practice Address - Phone:508-394-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice