Healthcare Provider Details

I. General information

NPI: 1144351511
Provider Name (Legal Business Name): PAULA PRINCE CASKEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST RM D104 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
LEXINGTON KY
40536-0297
US

IV. Provider business mailing address

800 ROSE ST RM D104 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
LEXINGTON KY
40536-0297
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-1345
  • Fax: 859-257-5859
Mailing address:
  • Phone: 859-323-1345
  • Fax: 859-257-5859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberKY4868
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number4868
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: