| NPI | 1265590061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD ELLIOT HAMBURG Dentist 502-897-1571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 3683) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: KY 148) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |