Provider Demographics
NPI:1578083044
Name:CIVETTI, ASHLEY ALYSE (DDS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ALYSE
Last Name:CIVETTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ALYSE
Other - Last Name:DOLBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1151 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1669
Mailing Address - Country:US
Mailing Address - Phone:561-798-4200
Mailing Address - Fax:
Practice Address - Street 1:1151 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1669
Practice Address - Country:US
Practice Address - Phone:561-798-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN227331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice