Provider Demographics
NPI:1376618405
Name:ASCHEMAN, DYLAN J (DDS)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:J
Last Name:ASCHEMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 4TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:PINE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55063-1604
Mailing Address - Country:US
Mailing Address - Phone:320-629-6703
Mailing Address - Fax:320-629-6768
Practice Address - Street 1:705 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:MN
Practice Address - Zip Code:55063-1604
Practice Address - Country:US
Practice Address - Phone:320-629-6703
Practice Address - Fax:320-629-6768
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND119351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice