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General NPI Number Information
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NPI Number | 1255910089
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 7303 US HIGHWAY 42
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City | FLORENCE
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State | KY
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Zip | 41042-1903
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Country | US
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Telephone | 592-830-0033
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Fax |
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Provider Business Mailing Address
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Address Line | 7303 US HIGHWAY 42
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City | FLORENCE
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State | KY
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Zip | 41042-1903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | HANNAH FISH
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Credential |
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Telephone | 217-540-5699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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