Provider Demographics
NPI:1942666805
Name:ASHLEY LAIRD, DDS
Entity Type:Organization
Organization Name:ASHLEY LAIRD, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-522-0650
Mailing Address - Street 1:1211 CLINIC DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2118
Mailing Address - Country:US
Mailing Address - Phone:903-522-0650
Mailing Address - Fax:
Practice Address - Street 1:1211 CLINIC DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2118
Practice Address - Country:US
Practice Address - Phone:903-522-0650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty