| NPI | 1841323268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JOHN GORMLEY Member 859-283-5775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 4002) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-01-27 |