Provider Demographics
NPI:1659697670
Name:ZERWECK, ASHLEY GIBBS (DMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:GIBBS
Last Name:ZERWECK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:EILEEN
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:4124 FULTON DR NW STE 102
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2852
Mailing Address - Country:US
Mailing Address - Phone:330-493-4700
Mailing Address - Fax:
Practice Address - Street 1:4124 FULTON DR NW STE 102
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2852
Practice Address - Country:US
Practice Address - Phone:330-493-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2014-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0232061223S0112X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery