| NPI | 1114299047 |
|---|---|
| Doing Business As | JESSAMINE DENTAL |
| Entity Type | Organization |
| Authorized Contact | CAROL ANN WILSON Dentist/Owner 859-885-5703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 8377) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KY 8377) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |