Individual
ASHLEY CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
983 N CENTER ST, CORRY, PA 16407-1228
(814) 664-4011
(814) 664-9376
Mailing address
983 N CENTER ST, CORRY, PA 16407-1228
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS040839
PA
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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