| NPI | 1710409370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYNN STAPLETON Front Office Assistant 859-287-2484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: KY 9038) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2022-07-21 |