| NPI | 1053734541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP R. WILLIAMS Owner 502-772-0704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 4776) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-04 |