Provider Demographics
NPI:1528687944
Name:ASHLEY, MICHAEL BLAIR (DDS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BLAIR
Last Name:ASHLEY
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 1:7411 RIGGS RD SUITE 101
Mailing Address - Street 2:
Mailing Address - City:HYALTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783
Mailing Address - Country:US
Mailing Address - Phone:301-439-5680
Mailing Address - Fax:301-439-1140
Practice Address - Street 1:7411 RIGGS RD SUITE 101
Practice Address - Street 2:
Practice Address - City:HYALTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783
Practice Address - Country:US
Practice Address - Phone:301-439-5680
Practice Address - Fax:301-439-1140
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice