| NPI | 1528119914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WHEELER President 502-543-2123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8107) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |