Healthcare Provider Details

I. General information

NPI: 1801323431
Provider Name (Legal Business Name): ASHLEY POLLICK DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2017
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20440 ROUTE 19
CRANBERRY TOWNSHIP PA
16066-7543
US

IV. Provider business mailing address

121 POLLICK LN
NEW KENSINGTON PA
15068-9504
US

V. Phone/Fax

Practice location:
  • Phone: 724-772-9688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS042407
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: