Provider Demographics
NPI:1184393902
Name:WERE, AMBER ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:ELIZABETH
Last Name:WERE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ELIZABETH
Other - Last Name:DUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2740 E COLLEGE AVE APT 120
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3124
Mailing Address - Country:US
Mailing Address - Phone:309-361-3995
Mailing Address - Fax:
Practice Address - Street 1:8180 MALL PKWY STE 810
Practice Address - Street 2:
Practice Address - City:STONECREST
Practice Address - State:GA
Practice Address - Zip Code:30038-6911
Practice Address - Country:US
Practice Address - Phone:770-484-4994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1224931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice