Provider Demographics
NPI:1043476419
Name:AMM, INC
Entity Type:Organization
Organization Name:AMM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-729-7511
Mailing Address - Street 1:1121 HWY 35 N
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-3112
Mailing Address - Country:US
Mailing Address - Phone:361-729-7511
Mailing Address - Fax:361-729-7651
Practice Address - Street 1:1121 HIGHWAY 35 N
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-3112
Practice Address - Country:US
Practice Address - Phone:361-729-7511
Practice Address - Fax:361-729-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19255261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental