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General NPI Number Information
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NPI Number | 1497889430
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Entity Type | Organization
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Legal Business Name | EDWARD AMBIS DDS PC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 118 W BUFFALO ST
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City | ITHACA
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State | NY
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Zip | 14850-4132
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Country | US
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Telephone | 607-272-1874
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Fax | 607-272-3076
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Provider Business Mailing Address
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Address Line | 118 W BUFFALO ST
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City | ITHACA
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State | NY
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Zip | 14850-4132
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Country | US
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Telephone | 607-272-1874
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Fax | 607-272-3076
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Authorized Official
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Title or Position | SECRETARY TREASURER
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Name | DOTTI AMBIS
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Credential |
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Telephone | 607-272-1874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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