Provider Demographics
NPI:1053806737
Name:BOETTGER, ASHLEY ALLYSON (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ALLYSON
Last Name:BOETTGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MILL STREAM RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-3400
Mailing Address - Country:US
Mailing Address - Phone:406-366-1811
Mailing Address - Fax:
Practice Address - Street 1:315 N 25TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1328
Practice Address - Country:US
Practice Address - Phone:406-248-6177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-154191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice