| NPI | 1245481175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HAROLD CIESLAK Owner 502-939-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KY 585) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |