Provider Demographics
NPI:1396408621
Name:BELL, AMY D (RDH, EPDH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:BELL
Suffix:
Gender:F
Credentials:RDH, EPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 690
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-0690
Mailing Address - Country:US
Mailing Address - Phone:541-248-0330
Mailing Address - Fax:
Practice Address - Street 1:442 SW UMATILLA AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-7039
Practice Address - Country:US
Practice Address - Phone:541-504-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH7585124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist