Maxam, Ashley
Maxam, Ashley is an individual health care provider with primary practice located at 1501 S Carbon St , Marion IL 62959-1435. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Maxam, Ashley can be contacted via phone (618) 997-7273.Contact Information
Primary practice address
1501 S Carbon St
Marion IL 62959-1435
Phone: (618) 997-7273
Fax: (618) 997-8978
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 019-028085 | Illinois |
Profile Details
| NPI number | 1124259130 |
|---|---|
| LBN Legal business name | Maxam, Ashley |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 7th, 2009 |
| Last updated | Oct 21st, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124259130 | NPPES |
| Illinois | Other | 019-028085 | STATE LICENSE NUMBER |
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