Healthcare Provider Details

I. General information

NPI: 1972757862
Provider Name (Legal Business Name): ASHER DENTAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 JAY ST.
FOSSIL OR
97830-0307
US

IV. Provider business mailing address

712 JAY ST.
FOSSIL OR
97830-0307
US

V. Phone/Fax

Practice location:
  • Phone: 541-763-2725
  • Fax: 541-763-2850
Mailing address:
  • Phone: 541-763-2725
  • Fax: 541-763-2850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JAMES IVAN CARLSON
Title or Position: ADMINISTRATOR
Credential: D.C.
Phone: 541-763-2725