Jared Ambrose Valid NPI
Individual provider · General Practice Dentistry · Fort Campbell, KY
- NPI
- 1548146038
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 11440 (KY)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2025-08-12
- Last updated
- 2025-08-12
Practice location
2441 21st St
Fort Campbell, KY 42223-5582
(270) 798-8953