Provider Demographics
NPI:1093712879
Name:COUNTS, AMY LYNN (DDS,MSD,MSM)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:COUNTS
Suffix:
Gender:F
Credentials:DDS,MSD,MSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 WATERMARK LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4111
Mailing Address - Country:US
Mailing Address - Phone:904-256-7855
Mailing Address - Fax:904-256-7889
Practice Address - Street 1:2800 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-3321
Practice Address - Country:US
Practice Address - Phone:904-256-7855
Practice Address - Fax:904-256-7889
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 172201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics