Organization
AMBROSE DENTAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES K. AMBROSE D.D.S. (OWNER)
(580) 782-5513
Entity
Organization
Contact information
Practice address
1410 1/2 N LOUIS TITTLE AVE, MANGUM, OK 73554-2218
(580) 782-5513
(580) 782-5156
Mailing address
PO BOX 326, MANGUM, OK 73554-0326
(580) 782-5513
(580) 782-5156
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4334
OK
Other
Enumeration date
04/21/2010
Last updated
04/21/2010
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