| NPI | 1548060098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PARDUE Director Of Revenue Cycle 502-548-2402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-03-14 |