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General NPI Number Information
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NPI Number | 1215101597
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Entity Type | Organization
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Legal Business Name | ASHFORD DENTAL INC. II
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 101 BECKETT LN SUITE 403
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7155
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Country | US
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Telephone | 770-461-0400
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Fax | 770-461-0280
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Provider Business Mailing Address
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Address Line | 101 BECKETT LN SUITE 403
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7155
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Country | US
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Telephone | 770-461-0400
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Fax | 770-461-0280
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBIN DWAYNE ASHFORD
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Credential | D.D.S.
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Telephone | 770-461-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9996
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License Number State | GA
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