Provider Demographics
NPI:1114311610
Name:CHRISTOPHER M. ASHBY DDS, INC.
Entity Type:Organization
Organization Name:CHRISTOPHER M. ASHBY DDS, INC.
Other - Org Name:FORT LORAMIE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-295-3400
Mailing Address - Street 1:PO BOX 318
Mailing Address - Street 2:20 S. MAIN ST.
Mailing Address - City:FORT LORAMIE
Mailing Address - State:OH
Mailing Address - Zip Code:45845-0318
Mailing Address - Country:US
Mailing Address - Phone:937-295-3400
Mailing Address - Fax:937-295-3370
Practice Address - Street 1:20 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:FORT LORAMIE
Practice Address - State:OH
Practice Address - Zip Code:45845-0318
Practice Address - Country:US
Practice Address - Phone:937-295-3400
Practice Address - Fax:937-295-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0209401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty