Provider Demographics
NPI:1942250014
Name:ASHCRAFT, DEBORAH A (DMD,PC)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:ASHCRAFT
Suffix:
Gender:F
Credentials:DMD,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 W MARTINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3106
Mailing Address - Country:US
Mailing Address - Phone:803-279-9901
Mailing Address - Fax:803-279-9215
Practice Address - Street 1:460 W MARTINTOWN RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3106
Practice Address - Country:US
Practice Address - Phone:803-279-9901
Practice Address - Fax:803-279-9215
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3364-4611223P0221X
GA113181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ33642Medicaid
GA00707165BMedicaid