Provider Demographics
NPI:1376725754
Name:SHAMBURGER, AMYE L (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMYE
Middle Name:L
Last Name:SHAMBURGER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:AMYE
Other - Middle Name:S
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:101 S. PEARL STREET
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051
Mailing Address - Country:US
Mailing Address - Phone:601-267-5111
Mailing Address - Fax:601-267-5335
Practice Address - Street 1:101 S. PEARL STREET
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051
Practice Address - Country:US
Practice Address - Phone:601-267-5111
Practice Address - Fax:601-267-5335
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3421-071223G0001X
MS34211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice