| NPI | 1184787822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY DAVID HERMAN Dentist 502-368-6852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 4335&4353) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2020-08-22 |