Individual
JAVIER AMBRIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7718 CASTOR AVE STE 1, PHILADELPHIA, PA 19152-3624
(215) 342-7718
Mailing address
7718 CASTOR AVE STE 1, PHILADELPHIA, PA 19152-3624
(215) 342-7718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS042984
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2019
Last updated
06/29/2021
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