| NPI | 1447468186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CORNISH Practice Manager 502-226-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6948) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |