Provider Demographics
NPI:1306413364
Name:AMOAH, AFIA POKUAA (DDS)
Entity type:Individual
Prefix:
First Name:AFIA
Middle Name:POKUAA
Last Name:AMOAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 FRANKLIN MILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-3140
Mailing Address - Country:US
Mailing Address - Phone:215-492-9291
Mailing Address - Fax:
Practice Address - Street 1:185 FRANKLIN MILLS BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3140
Practice Address - Country:US
Practice Address - Phone:215-492-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH-122300000X
OH30.0265621223G0001X
NJ22DI030202001223P0221X
PADS0445061223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty