| NPI | 1659408052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY PAUL KEATON President Owner 606-432-8165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2013-11-08 |