| NPI | 1255757852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA SCHULTEN Pediatric Dentist 270-789-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 8868) |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2022-07-06 |