Provider Demographics
NPI:1902185127
Name:TO, AMBROSE JING-HAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBROSE
Middle Name:JING-HAY
Last Name:TO
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 1:9701 NEW CHURCH ST STE 9
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2501
Mailing Address - Country:US
Mailing Address - Phone:301-253-2174
Mailing Address - Fax:
Practice Address - Street 1:9701 NEW CHURCH ST STE 9
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-2501
Practice Address - Country:US
Practice Address - Phone:301-253-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice