| NPI | 1396545083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF KING Owner 502-451-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-18 |