| NPI | 1366873929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DOANE Owner 502-498-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27592) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2014-01-29 |