| NPI | 1629233622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L WELLS President 859-224-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: KY 37301) |
| Enumeration Date | 2008-07-19 |
| Last Update Date | 2008-07-31 |