Most Relevant Information
Provider Data
| NPI Number: | 1003374919 |
| Provider Name: | MARINA AMBRIDGE DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | D010254 |
Most Important Dates
| Enumeration Date: | 03/10/2019 |
| Last Updated: | 03/10/2019 |
Provider Practice Location
25355 N LAKE PLEASANT PKWY UNIT 103
PEORIA
AZ
853831504
Practice Location Phone/Fax
| Phone: | 4804680335 |
| Fax: | 6238256885 |
Provider Mailing Location
25355 N LAKE PLEASANT PKWY UNIT 103
PEORIA
AZ
853831504
Provider Mailing Phone/Fax
| Phone: | 4804680335 |
| Fax: | 6238256885 |