Provider Demographics
NPI:1093970626
Name:C. ASHLEY MANN, DDS
Entity Type:Organization
Organization Name:C. ASHLEY MANN, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:CDPMA
Authorized Official - Phone:919-462-9338
Mailing Address - Street 1:315 E CHATHAM ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3472
Mailing Address - Country:US
Mailing Address - Phone:919-462-9338
Mailing Address - Fax:919-462-9386
Practice Address - Street 1:315 E CHATHAM ST
Practice Address - Street 2:STE. 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3472
Practice Address - Country:US
Practice Address - Phone:919-462-9338
Practice Address - Fax:919-462-9386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty