Provider Demographics
NPI:1598741746
Name:ASHE, KENNETH M (DDS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:M
Last Name:ASHE
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 1:43 SMITH RD
Mailing Address - Street 2:NAVAL HEALTH CARE NEW ENGLAND ATTN PROFESSIONAL AFFAIRS
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02841-1002
Mailing Address - Country:US
Mailing Address - Phone:401-841-4522
Mailing Address - Fax:401-841-4128
Practice Address - Street 1:650 SEWALL ST
Practice Address - Street 2:BRANCH HEALTH CLINIC NAVAL AIR STATION
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-5011
Practice Address - Country:US
Practice Address - Phone:207-921-1820
Practice Address - Fax:207-921-2992
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15944122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN