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General NPI Number Information
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NPI Number | 1952081820
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Entity Type | Individual
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Provider Name | ASHLEY FADDIS DDS
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 147 WILSON RD
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City | BENTLEYVILLE
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State | PA
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Zip | 15314-1027
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Country | US
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Telephone | 724-200-2994
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Fax |
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Provider Business Mailing Address
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Address Line | 395 KENNEL RD
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City | WAYNESBURG
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State | PA
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Zip | 15370-2603
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Country | US
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Telephone | 724-833-1051
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS044272
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License Number State | PA
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