| NPI | 1194899161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH WAYNE LOSE Partner 606-376-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 5243) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2014-10-15 |