Basic Information
| Provider Information | |||||||||
| NPI: | 1487232294 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TREHERNE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ASHHURST | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 316 RAILROAD AVE | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216361126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106342380 | ||||||||
| FaxNumber: | 8339161014 | ||||||||
| Practice Location | |||||||||
| Address1: | 316 RAILROAD AVE | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216361126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106342380 | ||||||||
| FaxNumber: | 8339161014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2021 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | LL885 | MD | Y | Dental Providers | Dentist |
No ID Information.