Provider Demographics
NPI:1336206655
Name:ASHFORD, ROBIN DWAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:DWAYNE
Last Name:ASHFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BECKETT LN
Mailing Address - Street 2:STE 404
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7159
Mailing Address - Country:US
Mailing Address - Phone:770-461-0400
Mailing Address - Fax:770-461-0280
Practice Address - Street 1:101 BECKETT LN
Practice Address - Street 2:SUITE 404
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7159
Practice Address - Country:US
Practice Address - Phone:770-461-0400
Practice Address - Fax:770-461-0280
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist