Provider Demographics
NPI:1972727527
Name:DAVID, AMY L (DMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:L
Last Name:DAVID
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 1:898 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0234
Mailing Address - Country:US
Mailing Address - Phone:212-534-5000
Mailing Address - Fax:212-650-0773
Practice Address - Street 1:898 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0234
Practice Address - Country:US
Practice Address - Phone:212-534-5000
Practice Address - Fax:212-650-0773
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0480871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice