| NPI | 1801903554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID STANFORD FERGUSON Partner 859-268-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 5024) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 3913) |
| 122300000X Dentist (Licence: KY 6707) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |