Healthcare Provider Details

I. General information

NPI: 1952389801
Provider Name (Legal Business Name): SHARON SCHWENDEMAN VETTER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 WALTON AVE
LEXINGTON KY
40502-1451
US

IV. Provider business mailing address

350 HANOVER DR
WINCHESTER KY
40391-8566
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-3030
  • Fax: 859-253-9428
Mailing address:
  • Phone: 859-737-2912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6538
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901017606
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: