Provider Demographics
NPI:1316116304
Name:SHEARER, AMY LYN (DMD)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYN
Last Name:SHEARER
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 1:108 N RUBEY DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-2455
Mailing Address - Country:US
Mailing Address - Phone:303-215-9949
Mailing Address - Fax:720-457-3893
Practice Address - Street 1:108 N RUBEY DR
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-2455
Practice Address - Country:US
Practice Address - Phone:303-215-9949
Practice Address - Fax:720-457-3893
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO94891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics