| NPI | 1962266296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHD KHALAF Owner 859-539-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X2210X Dentist Orofacial Pain |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-03-04 |