| NPI | 1811669922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A BARNETT Owner 502-671-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-11-22 |