| NPI | 1740562719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM THOMPSON Sole Officer 502-868-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8132) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |