| Provider / Organization | NPI | Date Certified |
|---|---|---|
| AMANDA NGHI TA | 1780265959 | 2021-04-19 |
Amanda Nghi Ta is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1780265959. Registration indicates Amanda Nghi Ta is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Dentists-General (Dental Providers, Dentist) (Dental Providers, Dentist) (Dentist: General Practice, ) (Dental, ) (Dentist General Practice, Dental Providers) (Dentist, )
| Entity Type | Individual |
| Provider Name | Dr. Amanda Nghi Ta DDS |
| Practice Office Address | 110 OPPORTUNITY BLVD S STE A CAMBRIDGE, MN US |
| Practice Office Telephone | 7633631277 |
| Mailing Address | 110 OPPORTUNITY BLVD S STE A CAMBRIDGE, MN 550082222 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3570 River Rapids Dr NW | Coon Rapids, MN 554484100 | 6515231093 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 1223G0001X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist: General Practice Dental Dentist General Practice Dental Providers Dentist | D14615
MN |