Provider Demographics
NPI:1518998293
Name:ASHY, MARK MILHEM (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:MILHEM
Last Name:ASHY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 MARINA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4820
Mailing Address - Country:US
Mailing Address - Phone:407-876-9892
Mailing Address - Fax:407-658-0037
Practice Address - Street 1:13000 AVALON LAKE DR
Practice Address - Street 2:STE 201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-6434
Practice Address - Country:US
Practice Address - Phone:407-658-0103
Practice Address - Fax:407-658-0037
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice