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General NPI Number Information
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NPI Number | 1306528161
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Entity Type | Individual
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Provider Name | AMY KATHRYN GREER RDH
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Gender | Female
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 104 W D.L. INGRAM AVE
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City | CANNON AFB
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State | NM
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Zip | 88101
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Country | US
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Telephone | 575-784-4041
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Fax |
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Provider Business Mailing Address
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Address Line | 25 REPUBLIC CT
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City | CLOVIS
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State | NM
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Zip | 88101-8336
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Country | US
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Telephone | 360-556-8807
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH5617
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License Number State | NM
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