Basic Information
Provider Information
NPI: 1003297508
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PLACE
FirstName: ASHLEY
MiddleName: PAPESH
NamePrefix:  
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PAPESH
OtherFirstName: ASHLEY
OtherMiddleName: MARIE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6655 POST RD
Address2:  
City: DUBLIN
State: OH
PostalCode: 430168214
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 6655 POST RD
Address2: SUITE A
City: DUBLIN
State: OH
PostalCode: 430168214
CountryCode: US
TelephoneNumber: 6143367643
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/10/2015
LastUpdateDate: 07/01/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X30.024508OHY Dental ProvidersDentist 

No ID Information.


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