NPI | 1760772230 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY T JOHNSON Owner 859-236-6900 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 7737) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 7737) |
Enumeration Date | 2011-04-18 |
Last Update Date | 2016-10-25 |