| NPI | 1740733559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN E MITCHELL Owner 502-552-8934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 9250) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-09-28 |