Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH21771 | FL |
N | 126800000X | Dental Assistant | 199364 | FL |
NPI | 1285907584 |
---|---|
Provider Name | Mrs. Amber Dawn Denny |
First Address | Rockledge, FL 32955-3838 |
Second Address | Indian Harbour Beach, FL 32937-4874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 16/02/2012 |