Individual
DR. JERROLD ROBERT AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1584 SAYBROOK RD, HADDAM, CT 06438
(860) 345-2404
Mailing address
1584 SAYBROOK ROAD, HADDAM, CT 06438
(860) 345-2404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4522
CT
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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