| NPI | 1740543990 |
|---|---|
| Doing Business As | DENTTIVA OR AOBA |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER PAUL BOWEN President 502-797-1567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3005577) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |