Provider Demographics
NPI:1720166093
Name:CALLIS, AMBER (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:CALLIS
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 1:103 FLUOR DANIEL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:713-272-0036
Mailing Address - Fax:713-272-7616
Practice Address - Street 1:103 FLUOR DANIEL DRIVE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:713-272-0036
Practice Address - Fax:713-272-7616
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice