| NPI | 1568539062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT R ROSS Owner President 859-371-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 6085) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: KY 4661) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: KY 8183) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |