| NPI | 1205012226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVEN RENEE STEELY Receptionist 859-647-7068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 7415) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8475) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |