| NPI | 1790175438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON MICHAEL HENDRICKS Dentist/Owner 859-368-8618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: KY 8627) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |