| NPI | 1790520773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN TRISLER Orthodontist 502-802-1281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |