| NPI | 1104832757 |
|---|---|
| Doing Business As | HAZARD ORTHODONTIC CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEREK GENE WATTS President 606-439-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 7013) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-02-25 |