Provider Demographics
NPI:1306405212
Name:ZIMM, ASHLEY MAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MAY
Last Name:ZIMM
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 1:320 W MYRTLE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4457
Mailing Address - Country:US
Mailing Address - Phone:218-491-8058
Mailing Address - Fax:
Practice Address - Street 1:320 W MYRTLE ST STE 100
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-4457
Practice Address - Country:US
Practice Address - Phone:218-491-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002040041223G0001X
MND145131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice