Provider Demographics
NPI:1134210404
Name:ASH, GEORGE M (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:ASH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5770 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9425
Mailing Address - Country:US
Mailing Address - Phone:734-747-9126
Mailing Address - Fax:734-747-8101
Practice Address - Street 1:5770 WARREN RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9425
Practice Address - Country:US
Practice Address - Phone:734-747-9126
Practice Address - Fax:734-747-8101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI110001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics