Provider Demographics
NPI:1215047881
Name:HATFIELD, AMBER NICHOLE WATTS (DMD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICHOLE WATTS
Last Name:HATFIELD
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 1:894 MAN O WAR BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091
Mailing Address - Country:US
Mailing Address - Phone:502-636-5492
Mailing Address - Fax:502-636-9210
Practice Address - Street 1:2333 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3215
Practice Address - Country:US
Practice Address - Phone:800-409-2563
Practice Address - Fax:502-636-9210
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8347122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist