| NPI | 1225214547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C HERREN Owner 606-864-4744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 7414) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2009-11-20 |