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1093866154
JACKIE L BANAHAN
LEXINGTON, KY
NPI
1093866154
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: KY 4977)
Enumeration Date
2007-01-16
Last Update Date
2007-07-08
Business Address
Dr. JACKIE L BANAHAN D.M.D.
3141 BEAUMONT CENTRE CIR SUITE 100
LEXINGTON, KY 40513-1934
Phone number: 859-223-4888
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Mailing Address
Dr. JACKIE L BANAHAN D.M.D.
3141 BEAUMONT CENTRE CIR SUITE 100
LEXINGTON, KY 40513-1934
Phone number: 859-223-4888
Copy
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