Provider Demographics
NPI:1962073510
Name:MILLS, AMBER M (DDS)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:MILLS
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 1:310 W BERTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:KS
Mailing Address - Zip Code:66536-1615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 WESTBURY DR STE 310
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2560
Practice Address - Country:US
Practice Address - Phone:636-723-6071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220140991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice