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General NPI Number Information
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NPI Number | 1861217358
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Entity Type | Organization
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Legal Business Name | DAVID ASHLEY MD DMD ORAL SURGERY GROUP, PC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 104 CLECO DR
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City | PINEVILLE
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State | LA
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Zip | 71360-5325
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Country | US
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Telephone | 337-541-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 511 BROOKWOOD BLVD
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City | HOMEWOOD
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State | AL
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Zip | 35209-6801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | DAVID ASHLEY
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Credential | MD DMD
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Telephone | 205-870-1009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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