Provider Demographics
NPI:1003114000
Name:MILLS, ASHLEY WIEST (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:WIEST
Last Name:MILLS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:WIEST
Other - Last Name:BLATTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:989 N. MOUNT AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701
Mailing Address - Country:US
Mailing Address - Phone:573-334-8013
Mailing Address - Fax:573-334-4101
Practice Address - Street 1:ROSS A BENNETT DDS PC BENNETT FAMILY DENTISTRY
Practice Address - Street 2:989 N. MOUNT AUBURN RD.
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701
Practice Address - Country:US
Practice Address - Phone:573-334-8013
Practice Address - Fax:573-334-4101
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14716122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist