Provider Demographics
NPI:1104442227
Name:BRIGMAN, AMBER GOODMAN (CDA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:GOODMAN
Last Name:BRIGMAN
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 HICKORY TREE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1616
Mailing Address - Country:US
Mailing Address - Phone:828-231-2014
Mailing Address - Fax:
Practice Address - Street 1:91 HICKORY TREE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1616
Practice Address - Country:US
Practice Address - Phone:828-231-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208546126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant