| NPI | 1619151180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE ABANG Office Manager 502-451-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 7297) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |