Provider Demographics
NPI:1407877020
Name:TEMPLE, AMY F (DDS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:F
Last Name:TEMPLE
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 1:840 SALISBURY ST
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-3032
Mailing Address - Country:US
Mailing Address - Phone:336-993-5599
Mailing Address - Fax:336-993-0877
Practice Address - Street 1:840 SALISBURY ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3032
Practice Address - Country:US
Practice Address - Phone:336-993-5599
Practice Address - Fax:336-993-0877
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC73331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902JUMedicaid