| NPI | 1073653853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARTER L BLEVINS Owner Oral Surgeon 606-679-7562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 4201) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-02-07 |