| NPI | 1558370031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN R GOULD Oral & Maxillofacial Pathologist 502-241-7116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: KY 4925) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IN 12010715A) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2017-01-13 |