Healthcare Provider Details

I. General information

NPI: 1396246906
Provider Name (Legal Business Name): DAVID ASHLEY ORAL & MAXILLOFACIAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2018
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 BROOKWOOD BLVD
BIRMINGHAM AL
35209-6801
US

IV. Provider business mailing address

2045 BROOKWOOD MEDICAL CTR DR STE 24
BIRMINGHAM AL
35209-6809
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-1009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number31809
License Number StateAL

VIII. Authorized Official

Name: DR. DAVID ASHLEY
Title or Position: OWNER
Credential: MD DMD
Phone: 205-870-8833