Provider Demographics
NPI:1184238818
Name:ASHLEY FAIELLA DMD, LLC
Entity type:Organization
Organization Name:ASHLEY FAIELLA DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-317-4715
Mailing Address - Street 1:140 EVARTS ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-1661
Mailing Address - Country:US
Mailing Address - Phone:201-317-4715
Mailing Address - Fax:
Practice Address - Street 1:706 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5796
Practice Address - Country:US
Practice Address - Phone:401-847-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty