Provider Demographics
NPI:1952683450
Name:AMBRIZ, ALBERTO (DDS, MDT)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:AMBRIZ
Suffix:
Gender:M
Credentials:DDS, MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 N CENTRAL EXPY STE 220
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5061
Mailing Address - Country:US
Mailing Address - Phone:214-368-0514
Mailing Address - Fax:
Practice Address - Street 1:9400 N CENTRAL EXPY STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5061
Practice Address - Country:US
Practice Address - Phone:214-368-0514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30812122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist