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1104235233
KELLY GOODPASTER WARREN
LEXINGTON, KY
NPI
1104235233
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: KY 10353)
Enumeration Date
2014-08-01
Last Update Date
2019-08-14
Business Address
Dr. KELLY GOODPASTER WARREN DMD
535 WELLINGTON WAY STE 120
LEXINGTON, KY 40503-1387
Phone number: 859-630-1315
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Mailing Address
Dr. KELLY GOODPASTER WARREN DMD
416 RIDGEWAY RD
LEXINGTON, KY 40502-2344
Phone number: 859-630-1315
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