Provider Demographics
NPI:1033305594
Name:CRARY, AMY E (DMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:CRARY
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 1:931 SE OCEAN BLVD
Mailing Address - Street 2:SUITE #B1
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2425
Mailing Address - Country:US
Mailing Address - Phone:772-463-4026
Mailing Address - Fax:772-463-4452
Practice Address - Street 1:931 SE OCEAN BLVD
Practice Address - Street 2:SUITE B1
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2425
Practice Address - Country:US
Practice Address - Phone:772-463-4026
Practice Address - Fax:772-463-4452
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN159511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice