Provider Demographics
NPI:1770111577
Name:BRODIGAN, ASHLEY E (DDS)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:E
Last Name:BRODIGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:E
Other - Last Name:BRODEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 WEST ST STE 202
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6517
Mailing Address - Country:US
Mailing Address - Phone:203-323-5439
Mailing Address - Fax:
Practice Address - Street 1:47 WEST ST STE 202
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6517
Practice Address - Country:US
Practice Address - Phone:203-323-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT142071223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry