| NPI | 1306903869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY ANDERSON Office Manager 606-528-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 5198) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |