Provider Demographics
NPI:1629117148
Name:PUHL, AMBER (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:PUHL
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 1:2234 VANESS DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2624
Mailing Address - Country:US
Mailing Address - Phone:419-343-7698
Mailing Address - Fax:
Practice Address - Street 1:5012 TALMADGE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-2167
Practice Address - Country:US
Practice Address - Phone:419-474-9611
Practice Address - Fax:419-474-1902
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300224091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice