Provider Demographics
NPI:1972174795
Name:AMOS, BRIANA L (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:L
Last Name:AMOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MACKAY DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-4503
Mailing Address - Country:US
Mailing Address - Phone:912-222-8282
Mailing Address - Fax:
Practice Address - Street 1:815 E 68TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4724
Practice Address - Country:US
Practice Address - Phone:912-355-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist