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General NPI Number Information
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NPI Number | 1467598912
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Entity Type | Organization
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Legal Business Name | KNOX FAMILY DENTISTRY, P.S.C.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 608 KNOX ST
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City | BARBOURVILLE
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State | KY
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Zip | 40906-1304
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Country | US
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Telephone | 606-546-6711
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Fax | 606-546-2574
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Provider Business Mailing Address
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Address Line | 608 KNOX ST
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City | BARBOURVILLE
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State | KY
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Zip | 40906-1304
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Country | US
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Telephone | 606-546-6711
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Fax | 606-546-2574
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRENT C. MCDONALD
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Credential | D.M.D.
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Telephone | 606-546-6711
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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 | 7384
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License Number State | KY
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