| NPI | 1487803367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA GOATLEY HAYDON Dentist/Owner Of Business 502-348-0908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 6676) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2008-09-16 |