| NPI | 1417024449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY D REYNOLDS Partner 859-278-0576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 6361) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 3285) |
| 122300000X Dentist (Licence: KY 5281) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |