Provider Demographics
NPI:1013222330
Name:CHARMICHAEL, ASHLEY LYNN (DDS)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:LYNN
Last Name:CHARMICHAEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W. RIDGEWAY AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701
Mailing Address - Country:US
Mailing Address - Phone:319-232-9023
Mailing Address - Fax:319-232-1610
Practice Address - Street 1:220 W. RIDGEWAY AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701
Practice Address - Country:US
Practice Address - Phone:319-232-9023
Practice Address - Fax:319-232-1610
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist