| NPI | 1760525604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL PELPHREY President 606-437-1461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 6229) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 6229) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-11-05 |