Provider Demographics
NPI:1528079613
Name:DAYRIES, AMY (DMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:DAYRIES
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 1:1240 UPPER HEMBREE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0914
Mailing Address - Country:US
Mailing Address - Phone:770-753-0067
Mailing Address - Fax:
Practice Address - Street 1:1240 UPPER HEMBREE RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0914
Practice Address - Country:US
Practice Address - Phone:770-753-0067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0115391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice