Provider Demographics
NPI:1154546943
Name:SAWYER, AMY SMITH (DMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:SMITH
Last Name:SAWYER
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 1:216 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3152
Mailing Address - Country:US
Mailing Address - Phone:985-327-7181
Mailing Address - Fax:985-327-7183
Practice Address - Street 1:216 W 21ST AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3152
Practice Address - Country:US
Practice Address - Phone:985-327-7181
Practice Address - Fax:985-327-7183
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0130971223X0400X
LA61841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics