Individual
JUSTIN TYLER AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
5632 THE ALAMEDA, BALTIMORE, MD 21239-2737
(410) 435-0008
Mailing address
8418 COCO RD, ROSEDALE, MD 21237-1843
(443) 564-7373
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7293
MD
124Q00000X
Dental Hygienist
DH.002025759
CO
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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