| NPI | 1114944816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA KAYE CORBIT Office Manager 502-499-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: KY 6418) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |