William Leslie Ambrose, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Jefferson City, MO

NPI

1316158009

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

12670 (MO)

Sex

Male

Sole proprietor

No

Enumerated

2007-05-24

Last updated

2007-07-08