| NPI | 1972024115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALLEB ANDERSON GREENE Owner/Dentist 270-885-6137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 9989) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2023-01-17 |