| NPI | 1588768758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHIE ARMSTRONG Director Of Credentialing 502-254-8501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2015-04-14 |