Individual
DR. ANTONIO CUASAY AMBAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
Mailing address
708 SE MADISON ST, APT B, IDABEL, OK 74745-5012
(518) 366-4770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414183
VA
Other
Enumeration date
09/14/2013
Last updated
01/21/2014
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