| NPI | 1124097365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH CHAMBERS Owner/President 606-451-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 6660) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-08-22 |