Derwood Lee Ashworth, D.D.S., M.SC.O.

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · North Wilkesboro, NC

NPI 1699897017 · NPPES record last updated Nov 13, 2007

Key facts

NPI
1699897017
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
Practice address
110A Wilkesboro Ave
North Wilkesboro, NC 28659-4218
Phone
(336) 667-4752
Fax
(336) 667-1693
NPI assigned
Apr 5, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2880NCMDOrthodontics and Dentofacial Orthopedic Dentist
56-0945513NCMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2880 NC
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NC Yes

Addresses

Primary practice location

110A Wilkesboro Ave
North Wilkesboro, NC 28659-4218

Mailing address

PO Box 1065
North Wilkesboro, NC 28659-1065
Phone (336) 667-4752

Other providers in North Wilkesboro, NC

All providers in North Wilkesboro, NC · Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.