| NPI | 1093134843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID THOMAS DODD Owner 502-897-5239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 5870) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |