Provider Demographics
NPI:1336384908
Name:PRINCE, ASHTON A (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHTON
Middle Name:A
Last Name:PRINCE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 W BRIGHAM RD STE 15
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7472
Mailing Address - Country:US
Mailing Address - Phone:435-656-8003
Mailing Address - Fax:435-628-6273
Practice Address - Street 1:144 W BRIGHAM RD STE 15
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7472
Practice Address - Country:US
Practice Address - Phone:435-656-8003
Practice Address - Fax:435-628-6273
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT702086099221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice