Provider Demographics
NPI:1962842047
Name:CASE, AMY PLOY (DDS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:PLOY
Last Name:CASE
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 1:2315 VIRGINIA PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3505
Mailing Address - Country:US
Mailing Address - Phone:972-562-0767
Mailing Address - Fax:972-548-0769
Practice Address - Street 1:2315 VIRGINIA PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3505
Practice Address - Country:US
Practice Address - Phone:972-562-0767
Practice Address - Fax:972-548-0769
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice