Provider Demographics
NPI:1578877288
Name:ASHLEY, DAVID CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:ASHLEY
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 1:8393 SW 78TH RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8703
Mailing Address - Country:US
Mailing Address - Phone:352-316-6661
Mailing Address - Fax:
Practice Address - Street 1:2477 STICKNEY POINT RD
Practice Address - Street 2:SUITE 109B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4076
Practice Address - Country:US
Practice Address - Phone:941-924-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN190261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice