| NPI | 1518827096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY L STEVENS Vice President Of Revenue Assurance 502-244-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-11-17 |
| Last Update Date | 2025-11-17 |