| NPI | 1376712471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SAMMONS Dentist 606-638-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: KY 6092) |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service (Licence: KY 6092) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2010-02-18 |