| NPI | 1821361940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ERNEST MONTAGUE Sole Officer 606-329-0919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 5224) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |