| NPI | 1104999218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE PATRICK STEWART Partner 270-866-8891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 5243) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-10-15 |