Individual
DR. AMBROSE ISIKHUEMEN OBHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3701 S MAIN ST STE A150, ELKHART, IN 46517-3140
(909) 674-4602
Mailing address
2301 W LEXINGTON AVE APT 105-2D, ELKHART, IN 46514-1480
(909) 674-4602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013236A
IN
Other
Enumeration date
03/31/2019
Last updated
07/16/2019
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