NPI | 1306220140 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENN R. BLINCOE President 502-895-2210 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2015-07-10 |
Last Update Date | 2016-12-22 |