| 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 |