| NPI | 1487737672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JOHN MASCARO Oresident 502-429-6506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KY 4617) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |