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Individual

DR. AMBROSE MILLER MARTIN III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2610 ESPLANADE AVE, NEW ORLEANS, LA 70119-3321
(504) 482-9919
(504) 482-9921
Mailing address
2610 ESPLANADE AVE, NEW ORLEANS, LA 70119-3321
(504) 482-9919
(504) 482-9921

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4671
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1846716
LA
01
970847
UNITED CONCORDIA
LA
Enumeration date
02/21/2007
Last updated
07/08/2007
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