| NPI | 1760975650 |
|---|---|
| Doing Business As | IDS SMILE LAB |
| Entity Type | Organization |
| Authorized Contact | BRANDON M STAPLETON Dentist/Owner 859-287-2484 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: KY 9038) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2020-01-16 |