Provider Demographics
NPI:1336375641
Name:ASHFIELD, AMANDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:ASHFIELD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:ELBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1015 CAMPBELL ST N
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:WI
Mailing Address - Zip Code:54021-1157
Mailing Address - Country:US
Mailing Address - Phone:715-262-3382
Mailing Address - Fax:
Practice Address - Street 1:1015 CAMPBELL ST N
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:WI
Practice Address - Zip Code:54021-1157
Practice Address - Country:US
Practice Address - Phone:715-262-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND126851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1223G0001XDental ProvidersDentistGeneral Practice