Individual
DR. AMANDA GAYNOR ASHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MSEDU, MS
Contact information
Practice address
234 NATCHEZ TRACE AVE, BOWLING GREEN, KY 42103-7995
(270) 715-5437
Mailing address
234 NATCHEZ TRACE AVE, BOWLING GREEN, KY 42103-7995
(270) 715-5437
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1010
AK
122300000X
Dentist
30-023178
OH
1223P0221X
Pediatric Dentistry
Primary
910
KY
1223P0221X
Pediatric Dentistry
9156
KY
1223P0221X
Pediatric Dentistry
9425
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100232870
—
KY
Enumeration date
03/19/2007
Last updated
07/09/2019
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