Provider Demographics
NPI:1780690644
Name:ASHBY, TERRI LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:LYNN
Last Name:ASHBY
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 1:204 TUTTLE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-6145
Mailing Address - Country:US
Mailing Address - Phone:210-820-8215
Mailing Address - Fax:
Practice Address - Street 1:935 EVENTIDE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5559
Practice Address - Country:US
Practice Address - Phone:210-824-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX189021223G0001X
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice