| NPI | 1326818238 |
|---|---|
| Doing Business As | FAITH DENTAL OF BEREA |
| Entity Type | Organization |
| Authorized Contact | LOGAN ROY ANTLE CEO 606-425-5768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-01-03 |