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General NPI Number Information
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NPI Number | 1467342345
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Entity Type | Individual
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Provider Name | L'CRIS AMARU REAL WEATHERS DMD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 1000 E JOHN ROWAN BLVD STE 101
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City | BARDSTOWN
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State | KY
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Zip | 40004-2060
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Country | US
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Telephone | 502-348-2589
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W LINCOLN TRAIL BLVD STE 25
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City | RADCLIFF
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State | KY
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Zip | 40160-3301
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Country | US
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Telephone | 502-772-0704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 11433
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License Number State | KY
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