Healthcare Provider Details

I. General information

NPI: 1003044918
Provider Name (Legal Business Name): ASHLEY FLOWERS, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 NORTH MAIN STREET
SPARTA NC
28675
US

IV. Provider business mailing address

507 NORTH MAIN STREET PO BOX 1870
SPARTA NC
28675
US

V. Phone/Fax

Practice location:
  • Phone: 336-372-3434
  • Fax: 336-372-1870
Mailing address:
  • Phone: 336-372-3434
  • Fax: 336-372-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number8817
License Number StateNC

VIII. Authorized Official

Name: DR. LAURA ASHLEY FLOWERS
Title or Position: DENTIST
Credential: D.D.S.
Phone: 336-372-3434