Provider Demographics
NPI:1962563700
Name:AMLANI, PRITI A (DMD)
Entity type:Individual
Prefix:DR
First Name:PRITI
Middle Name:A
Last Name:AMLANI
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 1:605 BROADWAY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-3283
Mailing Address - Country:US
Mailing Address - Phone:781-233-6844
Mailing Address - Fax:
Practice Address - Street 1:605 BROADWAY
Practice Address - Street 2:SUITE 301
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-3283
Practice Address - Country:US
Practice Address - Phone:781-233-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice