| NPI | 1184996035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE SLONE Office Manager 606-437-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6195) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 6195) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |