| NPI | 1790078905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JO DOWELL President 606-877-1466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8095) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8230) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2011-05-20 |