Provider Demographics
NPI:1912441353
Name:WARD, AMI (RDH)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:
Other - Last Name:CHRISTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2543 S SANDSTONE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9374
Mailing Address - Country:US
Mailing Address - Phone:517-769-4252
Mailing Address - Fax:
Practice Address - Street 1:505 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1266
Practice Address - Country:US
Practice Address - Phone:517-748-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-04
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902011055124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist