Provider Demographics
NPI:1245598853
Name:AMBURGEY, STEVEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:AMBURGEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2297
Mailing Address - Street 2:
Mailing Address - City:CHILHOWIE
Mailing Address - State:VA
Mailing Address - Zip Code:24319-2297
Mailing Address - Country:US
Mailing Address - Phone:276-646-0082
Mailing Address - Fax:
Practice Address - Street 1:112 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHILHOWIE
Practice Address - State:VA
Practice Address - Zip Code:24319
Practice Address - Country:US
Practice Address - Phone:276-646-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014110551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice