Healthcare Provider Details

I. General information

NPI: 1083253801
Provider Name (Legal Business Name): ASHLEY GIBBS ZERWECK DMD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 12/26/2019
Certification Date: 12/26/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 FULTON DR NW STE 102
CANTON OH
44718-2852
US

IV. Provider business mailing address

4124 FULTON DR NW STE 102
CANTON OH
44718-2852
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-4700
  • Fax: 330-493-8529
Mailing address:
  • Phone: 330-493-4700
  • Fax: 330-493-8529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHLEY GIBBS ZERWECK
Title or Position: OWNER
Credential: DMD
Phone: 330-904-7926