Provider Demographics
NPI:1487000733
Name:ANDREWS, AMY ELIZABETH (DMD, MDS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:DMD, MDS
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMY E PARKER
Mailing Address - Street 1:111 HILLDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-5723
Mailing Address - Country:US
Mailing Address - Phone:321-266-6639
Mailing Address - Fax:
Practice Address - Street 1:163 TOMOKA AVE
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6348
Practice Address - Country:US
Practice Address - Phone:386-672-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN202091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics