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General NPI Number Information
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NPI Number | 1730518986
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Entity Type | Organization
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Legal Business Name | ANDREW N AMBORSKI D.D.S, LLC
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 7461 E US HIGHWAY 36
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City | AVON
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State | IN
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Zip | 46123-7170
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Country | US
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Telephone | 317-272-3002
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Fax |
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Provider Business Mailing Address
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Address Line | 7461 E US HIGHWAY 36
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City | AVON
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State | IN
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Zip | 46123-7170
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ANDREW AMBORSKI
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Credential |
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Telephone | 248-790-6849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12011739A
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License Number State | IN
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