Provider Demographics
NPI:1457719627
Name:TATE, ASHLEY (DMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 DANCING WIND LN
Mailing Address - Street 2:APT 105
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-9660
Mailing Address - Country:US
Mailing Address - Phone:727-415-5915
Mailing Address - Fax:
Practice Address - Street 1:7505 GRAND LELY DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-1753
Practice Address - Country:US
Practice Address - Phone:239-775-3052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist