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General NPI Number Information
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NPI Number | 1902153869
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Entity Type | Individual
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Provider Name | ASHLIE BROOKE DOHMAN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 199 STATE RT 284
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City | WANTAGE
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State | NJ
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Zip | 07461-3417
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Country | US
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Telephone | 973-875-7127
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 RIVERDALE RD APT 301
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City | RIVERDALE
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State | NJ
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Zip | 07457-1726
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Country | US
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Telephone | 443-532-5955
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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 | 22DI02539400
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License Number State | NJ
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