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General NPI Number Information
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NPI Number | 1437346780
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Entity Type | Organization
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Legal Business Name | DESIGNING SMILES
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 630 COMANCHE TR STE A
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City | FRANKFORT
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State | KY
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Zip | 40601
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Country | US
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Telephone | 502-226-1900
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Fax | 502-226-1990
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Provider Business Mailing Address
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Address Line | 630 COMANCHE TR STE A
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City | FRANKFORT
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State | KY
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Zip | 40601
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Country | US
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Telephone | 502-226-1900
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Fax | 502-226-1990
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Authorized Official
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Title or Position | AR MANAGER
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Name | JULIE LYNN SANDIFER
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Credential |
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Telephone | 502-226-1900
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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 | 5876
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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 | 8429
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License Number State | KY
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