Provider Demographics
NPI:1285907584
Name:DENNY, AMBER DAWN (RDH, CDA)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DAWN
Last Name:DENNY
Suffix:
Gender:F
Credentials:RDH, CDA
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:DAWN
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH, CDA
Mailing Address - Street 1:1020 GENEVIEVE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3838
Mailing Address - Country:US
Mailing Address - Phone:321-213-1852
Mailing Address - Fax:
Practice Address - Street 1:214 E EAU GALLIE BLVD
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4874
Practice Address - Country:US
Practice Address - Phone:321-779-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH21771124Q00000X
FL199364126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No126800000XDental ProvidersDental Assistant