MEDICARE: ASHLEY ELIZABETH PRICE D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	8426	SC

General Provider Information

NPI Number	:	1215344601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ELIZABETH PRICE D.M.D.

Provider Business Mailing Address
First Line	:	1915 SOUTH LAKE DRIVE
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073
Country	:	US
Telephone Number	:	803-516-1166
Fax Number	:	803-785-4601

Provider Business Practice Location Address
First Line	:	1915 SOUTH LAKE DRIVE
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-7763
Country	:	US
Telephone Number	:	803-516-1166
Fax Number	:	803-785-4600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	06/13/2016

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