NPI | 1063808277 |
---|---|
Entity Type | Organization |
Authorized Contact | DENITA DAVIS Hr & Practice Manager 502-744-3988 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8660) |
Enumeration Date | 2015-04-14 |
Last Update Date | 2015-04-14 |