| NPI | 1023476652 |
|---|---|
| Doing Business As | AMBROSE PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TINA LOCHER Office Manager 478-743-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012737) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN007573) |
| 1223G0001X Dentist, General Practice (Licence: GA DN013328) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013383) | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-02-10 |