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General NPI Number Information
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NPI Number | 1396974036
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Entity Type | Organization
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Legal Business Name | LAUREL DENTAL CARE
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 1303 S LAUREL RD
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City | LONDON
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State | KY
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Zip | 40744-8304
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Country | US
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Telephone | 606-877-2700
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Fax | 606-877-9190
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Provider Business Mailing Address
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Address Line | 1303 S LAUREL RD
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City | LONDON
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State | KY
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Zip | 40744-8304
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Country | US
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Telephone | 606-877-2700
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Fax | 606-877-9190
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Authorized Official
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Title or Position | OWNER
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Name | DR. BARRY V BINGHAM
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Credential | DMD
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Telephone | 606-877-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8211
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6278
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License Number State | KY
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