Individual
MRS. DIANNE HOLLY AMBROSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDA,E.F.D.A
Contact information
Practice address
652 HAMILTON ROAD, FORT SILL, OK 73503
(580) 442-3905
(580) 442-4002
Mailing address
652 HAMILTON ROAD, FORT SILL, OK 73503
(580) 442-3905
(580) 442-4002
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
06/17/2016
Last updated
07/08/2016
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