| NPI | 1700229051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY BRIAN CUNNINGHAM Manager 270-705-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 8725) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2013-04-16 |