| NPI | 1265561872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER R. CIAMPA President 270-442-4374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 5552) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 5552) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2010-08-16 |