Provider Demographics
NPI:1497780621
Name:AMBLER, DONALD W (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:W
Last Name:AMBLER
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 1:494 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-9648
Mailing Address - Country:US
Mailing Address - Phone:828-321-1444
Mailing Address - Fax:828-321-1511
Practice Address - Street 1:494 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-9648
Practice Address - Country:US
Practice Address - Phone:828-321-1444
Practice Address - Fax:828-321-1511
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3887OtherSTATE LICENSE