| NPI | 1295011880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET M. LONGEST Office Mgr. 270-781-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6137) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |