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General NPI Number Information
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NPI Number | 1477246387
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Entity Type | Individual
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Provider Name | AMBER DALAL
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Gender | Female
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Dates
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Enumeration Date | 05/29/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 1624 CHOTO MARKETS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-5760
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Country | US
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Telephone | 865-409-5077
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Fax |
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Provider Business Mailing Address
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Address Line | 3875 NORTHWAY CIR
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City | POWELL
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State | OH
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Zip | 43065-7110
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Country | US
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Telephone | 908-590-1753
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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 | 30.027143
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12197
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License Number State | TN
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