Provider Demographics
NPI:1265846935
Name:MCCARVILLE, AMBER LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:MCCARVILLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SANFORD
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101
Mailing Address - Country:US
Mailing Address - Phone:563-382-2441
Mailing Address - Fax:563-382-6048
Practice Address - Street 1:501 SANFORD
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101
Practice Address - Country:US
Practice Address - Phone:563-382-2441
Practice Address - Fax:563-382-6048
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADOS-090901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice