| NPI | 1134323165 |
|---|---|
| Doing Business As | DESTINY DENTAL |
| Entity Type | Organization |
| Authorized Contact | GINA RENEE DAVIS Dentist 270-842-3554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 6708) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2016-02-02 |