| NPI | 1568891471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN VON ROENN Partner 502-584-1322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6527) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2013-11-01 |