| NPI | 1578930095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN AMBROSE Owner/Dentist 478-275-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 9603) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |