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General NPI Number Information
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NPI Number | 1235204017
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Entity Type | Organization
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Legal Business Name | AMLEY & AMLEY ORTHODONTICS, P.A.
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 5753 FIRST AVE. N.
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City | ST PETERSBURG
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State | FL
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Zip | 33710-7913
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Country | US
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Telephone | 727-381-1062
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Fax | 727-343-8337
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Provider Business Mailing Address
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Address Line | 5753 FIRST AVE. N.
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City | ST PETERSBURG
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State | FL
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Zip | 33710-7913
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Country | US
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Telephone | 727-381-1062
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Fax | 727-343-8337
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Authorized Official
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Title or Position | SECRETARY/TREASURER/PARTNER
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Name | DR. ROBERT B AMLEY
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Credential | D.D.S.
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Telephone | 727-381-1062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN5143
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN4233
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License Number State | FL
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