Provider Demographics
NPI:1568692937
Name:SOJOURNER, AMY LEIGH (DDS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEIGH
Last Name:SOJOURNER
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 1:525 BENELLI DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7014
Mailing Address - Country:US
Mailing Address - Phone:325-660-2862
Mailing Address - Fax:
Practice Address - Street 1:3109 S 27TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6239
Practice Address - Country:US
Practice Address - Phone:325-692-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24604122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist