Healthcare Provider Details
I. General information
NPI: 1427453711
Provider Name (Legal Business Name): ARROW DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2014
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3141 BEAUMONT CENTRE CIR SUITE 200
LEXINGTON KY
40513-1960
US
IV. Provider business mailing address
105 SPRUCE ST
LEXINGTON KY
40507-2109
US
V. Phone/Fax
- Phone: 859-296-4846
- Fax: 859-296-2842
- Phone: 859-296-4846
- Fax: 859-296-2842
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | 6263 |
| License Number State | KY |
VIII. Authorized Official
Name: DR.
JAMES
GREG
WHITE
Title or Position: ORTHODONTIST/OWNER
Credential: DMD, MS
Phone: 859-296-4846