| NPI | 1568572105 |
|---|---|
| Former Legal Business Name | DR C STEVEN HIERONYMUS |
| Entity Type | Organization |
| Authorized Contact | CHARLES STEVEN HIERONYMUS Doctor Owner 606-679-1204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 5256) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: KY 2697) |
| 124Q00000X Dental Hygienist (Licence: KY 3491) | |
| 124Q00000X Dental Hygienist (Licence: KY 2475) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |