Individual
AMBROSE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
7450 ALBERT RD FL 1, BRANDYWINE, MD 20613-3035
(301) 836-9645
Mailing address
7450 ALBERT RD FL 3, BRANDYWINE, MD 20613-3035
(301) 599-0460
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7504
MD
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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