| NPI | 1558640821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT AKRIDGE Orthodontist 502-244-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |