| NPI | 1316133499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LARGENT Owner/Dentist 270-554-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: KY 5466) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2013-01-23 |