Individual
ASHLEY LORAN CONLEY-FASONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8418 NEW TOWN RD, WAXHAW, NC 28173-8302
(047) 843-2880
Mailing address
6555 KINDER LN, LANCASTER, SC 29720-0405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12834
NC
1223G0001X
General Practice Dentistry
10190
SC
Other
Enumeration date
02/16/2022
Last updated
11/29/2022
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