| NPI | 1649543034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN BRENT CHUMBLEY President Owner 606-523-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: KY 4318) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |