Provider Demographics
NPI:1235570094
Name:DASON, ASH MOSES (DDS)
Entity Type:Individual
Prefix:
First Name:ASH
Middle Name:MOSES
Last Name:DASON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22780 VISTA GRANDE WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-4943
Mailing Address - Country:US
Mailing Address - Phone:951-310-4084
Mailing Address - Fax:
Practice Address - Street 1:944 VIA LATA
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3918
Practice Address - Country:US
Practice Address - Phone:951-310-4084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62483122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist