Provider Demographics
NPI:1992366116
Name:DECKER, ASHLEY ELAINE (DDS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELAINE
Last Name:DECKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N OAKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-7778
Mailing Address - Country:US
Mailing Address - Phone:682-558-1446
Mailing Address - Fax:
Practice Address - Street 1:114 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4312
Practice Address - Country:US
Practice Address - Phone:682-558-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist