Healthcare Provider Details

I. General information

NPI: 1386192011
Provider Name (Legal Business Name): ASE DENTAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2016
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 GEORGIA AVE STE 207 SILVER SPRING, MD 20902
SILVER SPRING MD
20902-5020
US

IV. Provider business mailing address

10301 GEORGIA AVE STE 207 SILVER SPRING, MD 20902
SILVER SPRING MD
20902-5020
US

V. Phone/Fax

Practice location:
  • Phone: 301-593-5500
  • Fax:
Mailing address:
  • Phone: 301-593-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12137
License Number StateMD

VIII. Authorized Official

Name: DR. ALICE MARIE CHARLAND BASSFORD
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 301-593-5500