| NPI | 1457637522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MARVIN JOLLY Owner 606-439-4581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 5604) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2011-11-02 |