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General NPI Number Information
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NPI Number | 1104558824
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Entity Type | Individual
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Provider Name | ASHLEIGH DIANA KMENTT DMD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 385 S COLUMBIA STREET
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City | CHAPEL HILL
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State | NC
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Zip | 27599
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Country | US
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Telephone | 919-537-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 9088 WHITE OAK RD
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City | KIRTLAND
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State | OH
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Zip | 44094-9752
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Country | US
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Telephone | 440-256-9088
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 000000
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License Number State | NC
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