| 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 |