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General NPI Number Information
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NPI Number | 1326409186
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Entity Type | Organization
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Legal Business Name | BRIAN L. AMISON, DDS, LLC
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 3684 DRESSLER RD NW SUITE A
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City | CANTON
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State | OH
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Zip | 44718-2781
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Country | US
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Telephone | 330-452-2255
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Fax | 330-452-2293
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Provider Business Mailing Address
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Address Line | 3684 DRESSLER RD NW SUITE A
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City | CANTON
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State | OH
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Zip | 44718-2781
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Country | US
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Telephone | 330-452-2255
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Fax | 330-452-2293
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN LAMAR AMISON
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Credential |
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Telephone | 330-452-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 20925
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License Number State | OH
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