| NPI | 1588204655 |
|---|---|
| Doing Business As | KIDS DENTISTREE - GLENMARY |
| Entity Type | Organization |
| Authorized Contact | JEFF REIBEL CFO 502-254-8500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2023-09-06 |