Provider Demographics
NPI:1104487743
Name:AMAT, MORGANE CHLOE (DMD)
Entity type:Individual
Prefix:DR
First Name:MORGANE
Middle Name:CHLOE
Last Name:AMAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-5003
Mailing Address - Country:US
Mailing Address - Phone:781-599-2900
Mailing Address - Fax:
Practice Address - Street 1:77 BROAD ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-5003
Practice Address - Country:US
Practice Address - Phone:781-599-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18589861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry