Provider Demographics
NPI:1801184494
Name:MYERS, AMBER DOMINIQUE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:DOMINIQUE
Last Name:MYERS
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 1:121 VICKERY HILL CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7736
Mailing Address - Country:US
Mailing Address - Phone:919-332-8293
Mailing Address - Fax:
Practice Address - Street 1:2700 S MIAMI BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9416
Practice Address - Country:US
Practice Address - Phone:919-598-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice