Provider Demographics
NPI:1659471274
Name:AMBUS, TONI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:
Last Name:AMBUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 JENEVEIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066
Mailing Address - Country:US
Mailing Address - Phone:650-588-7473
Mailing Address - Fax:
Practice Address - Street 1:773 JENEVEIN AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4231
Practice Address - Country:US
Practice Address - Phone:650-588-7473
Practice Address - Fax:650-588-7403
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice