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General NPI Number Information
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NPI Number | 1093935843
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Entity Type | Organization
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Legal Business Name | DRS. KNIGHT AND WAHLE ORTHODONTICS
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2533 LARKIN RD
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City | LEXINGTON
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State | KY
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Zip | 40503-3278
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Country | US
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Telephone | 859-277-6113
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Fax | 859-278-0798
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Provider Business Mailing Address
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Address Line | 2533 LARKIN RD
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City | LEXINGTON
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State | KY
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Zip | 40503-3278
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Country | US
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Telephone | 859-277-6113
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Fax | 859-278-0798
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUDSON MCCLUNG KNIGHT
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Credential | DMD
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Telephone | 859-277-6113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | KY
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