| NPI | 1134250608 |
|---|---|
| Doing Business As | FAMILY DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | DWIGHT PATRICK PETERS Co Owner (CFO) 502-223-0211 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 7615) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 5885) |
| 1223G0001X Dentist, General Practice (Licence: KY 7615) | |
| 1223G0001X Dentist, General Practice (Licence: KY 5203) | |
| 1223G0001X Dentist, General Practice (Licence: KY 3950) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 6543) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-07-29 |