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General NPI Number Information
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NPI Number | 1437453552
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Entity Type | Organization
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Legal Business Name | GENTLE CARE FAMILY DENTISTRY
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 650 N MAIN ST
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City | MONTICELLO
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State | KY
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Zip | 42633-1536
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Country | US
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Telephone | 606-348-5100
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Fax | 606-348-4849
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Provider Business Mailing Address
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Address Line | 650 NORTH MAIN STREET
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City | MONTICELLO
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State | KY
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Zip | 42633
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Country | US
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Telephone | 606-348-5100
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Fax | 606-348-4849
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MISTY JONES
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Credential |
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Telephone | 606-348-5100
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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 | 7403
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License Number State | KY
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