Ashlock, Jack R

Ashlock, Jack R is an individual health care provider with primary practice located at 6821 N Country Homes Blvd Ste 202, Spokane WA 99208-4372. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ashlock, Jack R can be contacted via phone (509) 327-8681.

Contact Information

Primary practice address
6821 N Country Homes Blvd Ste 202 Spokane WA 99208-4372
Phone: (509) 327-8681
Fax: (509) 327-8562
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 4470 Washington

Profile Details

NPI number 1174505002
LBN Legal business name Ashlock, Jack R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174505002 NPPES
Washington Other 591231 UNITED CONCORDIA PROVIDER
Washington MEDICAID 5397203 UNITED CONCORDIA PROVIDER

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