| NPI | 1437346780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE LYNN SANDIFER Ar Manager 502-226-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 8429) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 5876) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |