| NPI | 1720444532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DENISE STEVENS Office Manager 270-256-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 4281) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |