Individual
DR. JACK R ASHLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6821 N COUNTRY HOMES BLVD, STE 202, SPOKANE, WA 99208-4372
(509) 327-8681
(509) 327-8562
Mailing address
12105 N RIVERWOOD DR, SPOKANE, WA 99218-3500
(509) 468-2068
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4470
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5397203
—
WA
01
—
591231
UNITED CONCORDIA PROVIDER
WA
Enumeration date
11/16/2005
Last updated
07/09/2007
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