| NPI | 1417125733 |
|---|---|
| Doing Business As | IMMEDIADENT |
| Entity Type | Organization |
| Authorized Contact | RYAN E KLOBOVES Pc President 502-452-1886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010746A) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |