Provider Demographics
NPI:1972757862
Name:ASHER DENTAL SERVICES
Entity type:Organization
Organization Name:ASHER DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-763-2725
Mailing Address - Street 1:712 JAY ST.
Mailing Address - Street 2:
Mailing Address - City:FOSSIL
Mailing Address - State:OR
Mailing Address - Zip Code:97830-0307
Mailing Address - Country:US
Mailing Address - Phone:541-763-2725
Mailing Address - Fax:541-763-2850
Practice Address - Street 1:712 JAY ST.
Practice Address - Street 2:
Practice Address - City:FOSSIL
Practice Address - State:OR
Practice Address - Zip Code:97830-0307
Practice Address - Country:US
Practice Address - Phone:541-763-2725
Practice Address - Fax:541-763-2850
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHER COMMUNITY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare