| NPI | 1760929103 |
|---|---|
| Doing Business As | KIDS DENTISTREE - MAINEVILLE |
| Entity Type | Organization |
| Authorized Contact | JEFF REIBEL CFO 502-254-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2022-12-15 |