Healthcare Provider Details

I. General information

NPI: 1235562836
Provider Name (Legal Business Name): AMY M GREENSPAN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY M DULIN

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SPRING ST.
HERMITAGE MO
65668-0125
US

IV. Provider business mailing address

303 SPRING ST.
HERMITAGE MO
65668
US

V. Phone/Fax

Practice location:
  • Phone: 816-560-0141
  • Fax:
Mailing address:
  • Phone: 816-560-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2013026526
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: