| NPI | 1619045739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY G ANGELL Owner 502-425-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 4934) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |