| NPI | 1730200643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R. BISHOP Owner 859-887-1094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 5844) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |