| NPI | 1508162629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY W ALLEN Dentist 606-231-0594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8365) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 8365) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-03-22 |