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General NPI Number Information
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NPI Number | 1376151506
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Entity Type | Individual
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Provider Name | AMBER LYNNE PEARCE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 208 PARKWAY BLVD
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City | ELIZABETHTON
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State | TN
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Zip | 37643-2845
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Country | US
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Telephone | 423-543-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W WATAUGA AVE APT 5
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6476
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Country | US
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Telephone | 423-544-4286
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11320
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License Number State | TN
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