| NPI | 1316921703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS L MATTINGLY Vice President 502-895-3473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 7289) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2008-03-06 |