Provider Demographics
NPI:1942373907
Name:ASHTON, LOYE A (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:LOYE
Middle Name:A
Last Name:ASHTON
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1481
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58802-1481
Mailing Address - Country:US
Mailing Address - Phone:701-572-9461
Mailing Address - Fax:701-572-6762
Practice Address - Street 1:120 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801
Practice Address - Country:US
Practice Address - Phone:701-572-9461
Practice Address - Fax:701-572-6762
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND13361223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011 2788OtherMEDICAID
ND40468Medicaid