Provider Demographics
NPI:1205038692
Name:ASCOUGH, EVELYN G (DDS)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:G
Last Name:ASCOUGH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8953 COMPLEX DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1405
Mailing Address - Country:US
Mailing Address - Phone:619-298-0821
Mailing Address - Fax:619-298-0831
Practice Address - Street 1:8953 COMPLEX DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1405
Practice Address - Country:US
Practice Address - Phone:619-298-0821
Practice Address - Fax:619-298-0831
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice