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General NPI Number Information
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NPI Number | 1659321735
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Entity Type | Organization
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Legal Business Name | DEBORAH A. ASHCRAFT, D.M.D.,P.C.
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 460 W MARTINTOWN RD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3106
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Country | US
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Telephone | 803-279-9901
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Fax | 803-279-9215
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Provider Business Mailing Address
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Address Line | 460 W MARTINTOWN RD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3106
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Country | US
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Telephone | 803-279-9901
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Fax | 803-279-9215
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LILLIAN D PETERSON
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Credential |
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Telephone | 803-279-9901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 11318
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3364-461
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License Number State | SC
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