| NPI | 1326474099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT DOUGLAS KIDD Owner/Operator 606-776-9863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9075) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |