Individual
DR. CHARLES MARQUISS ASHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7505 38TH AVE, KENOSHA, WI 53142-4341
(262) 694-7522
(262) 697-9501
Mailing address
7505 38TH AVE, KENOSHA, WI 53142-4341
(262) 694-7522
(262) 697-9501
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000741-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33638000
—
WI
Enumeration date
03/15/2007
Last updated
07/09/2007
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