Provider Demographics
NPI:1588046676
Name:WELPER, AMBER DAWN (DDS)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:DAWN
Last Name:WELPER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-3106
Mailing Address - Country:US
Mailing Address - Phone:307-745-5020
Mailing Address - Fax:307-745-0856
Practice Address - Street 1:352 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-3106
Practice Address - Country:US
Practice Address - Phone:307-745-5020
Practice Address - Fax:307-745-0856
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY14141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY140858500Medicaid