| NPI | 1457699100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHIE ARMSTRONG Director Of Credentialing 502-254-8501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-01-30 |