Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | DA0000007585 | TN |
NPI | 1265578496 |
---|---|
Provider Name | Ashley Dawn Rushing |
First Address | Oneida, TN 37841-2812 |
Second Address | Huntsville, TN 37756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |