Ampt, LLC
Organization Active NPI Dental Clinic/Center · Poplar Bluff, MO
NPI 1780426445 · NPPES record last updated Jun 12, 2024
Key facts
- NPI
- 1780426445
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- AMPT, LLC
- Practice address
- 2990 Raider Way
Poplar Bluff, MO 63901-5372 - Phone
- (573) 785-6699
- Fax
- (573) 785-3424
- NPI assigned
- Jun 12, 2024
- Organization subpart
- No
Authorized official
- Name
- Dr. Anderson Mark Gilberto, DDS
- Title
- Owner
- Phone
- (573) 785-6699
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250711001733 | MO | Part B Supplier - Clinic/Group Practice | 2567988827 |
Receives reassigned benefits from 1 practitioner Practice locations: Poplar Bluff, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
2990 Raider Way
Poplar Bluff, MO 63901-5372
Mailing address
2990 Raider Way
Poplar Bluff, MO 63901-5372
Phone (573) 785-6699
Other names
- Gilberto and Hillis Dentistry
Other providers in Poplar Bluff, MO
- Napoleon Almaria
- Donna L Almond
- Connie Jean Alsup
- Alternative Sleep Solution
- Amedisys Missouri, L.L.C.
- Richard Armen Amundsen
- Manish Anand
- Anchorpoint Medical of the Ozarks
- Bailey Shea Anderson
- Ciara Anderson
All providers in Poplar Bluff, MO · Dental Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.