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NPI Code Detail

MEDICARE: DR. AMY LYNN COUNTS DDS,MSD,MSM

MEDICARE: DR. AMY LYNN COUNTS DDS,MSD,MSM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN 17220FL

General Provider Information

NPI Number : 1093712879
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY LYNN COUNTS DDS,MSD,MSM
Provider Business Mailing Address
First Line : 7750 WATERMARK LN
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-4111
Country : US
Telephone Number : 904-256-7855
Fax Number : 904-256-7889
Provider Business Practice Location Address
First Line : 2800 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-3321
Country : US
Telephone Number : 904-256-7855
Fax Number : 904-256-7889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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