| NPI | 1649765462 |
|---|---|
| Doing Business As | BBB - DIXIE TRENT AVE |
| Entity Type | Organization |
| Authorized Contact | STEPHEN JAMES CFO 502-254-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |