| NPI | 1942370093 |
|---|---|
| Other Name | AVON GENTLE DENTLST |
| Entity Type | Organization |
| Authorized Contact | TIM HOAGLAND Executive 502-423-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12012042) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-10-10 |