| NPI | 1205081247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE HAUNER Owner 502-448-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2018-07-23 |