| NPI | 1750027413 |
|---|---|
| Former Legal Business Name | MAYSVILLE PEDIATRIC DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MACKENZIE LUCAS Owner/Dentist 606-934-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-05-06 |