Timothy L. Ambrose, DDS
Dentist in Gallup, NM. Individual provider (NPI-1).
NPI number1003850116
StatusActive
Last updated in NPPESApr 16, 2008
Details
- NPI
- 1003850116
- Entity type
- Individual (NPI-1)
- Name
- Timothy L. Ambrose
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2006
- Last updated
- Apr 16, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 5767 | NE | Yes |
Practice location
516 E. Nizhoni Blvd.Gallup, NM 87301-1337
Phone 505-722-1000 · Fax 505-722-1565
Mailing address
Po Box 1337Gallup, NM 87305-1337
Phone 505-722-1000 · Fax 505-722-1565
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