Provider Demographics
NPI:1558174680
Name:DAVID ASHLEY MD DMD ORAL SURGERY GROUP, A PROFESSIONAL DENTAL CORPORAT
Entity type:Organization
Organization Name:DAVID ASHLEY MD DMD ORAL SURGERY GROUP, A PROFESSIONAL DENTAL CORPORAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HOUSTON
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:501-208-1593
Mailing Address - Street 1:511 BROOKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6801
Mailing Address - Country:US
Mailing Address - Phone:334-471-0625
Mailing Address - Fax:
Practice Address - Street 1:10235 JEFFERSON HWY BLDG 5
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3196
Practice Address - Country:US
Practice Address - Phone:337-541-2260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty