Individual
TIMOTHY L. AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5767
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000R7575
—
NM
05
—
416455
—
AZ
Enumeration date
06/16/2006
Last updated
04/16/2008
Update your record
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