Provider Demographics
NPI:1093732885
Name:ASHBA, CHRISTIANE (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:
Last Name:ASHBA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2019
Mailing Address - Country:US
Mailing Address - Phone:518-371-0636
Mailing Address - Fax:
Practice Address - Street 1:654 PLANK RD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-2019
Practice Address - Country:US
Practice Address - Phone:518-371-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice