| NPI | 1982722013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JAMES CFO 502-254-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA DN013242) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2018-08-24 |