| NPI | 1487767901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN D SPRADLIN President/Owner 606-329-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: KY 5782) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |