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General NPI Number Information
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NPI Number | 1548850027
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Entity Type | Organization
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Legal Business Name | KENTUCKY FAMILY DENTISTRY
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 301 E CENTRAL ST
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City | HARLAN
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State | KY
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Zip | 40831-2303
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Country | US
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Telephone | 606-573-2822
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 842
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City | HARLAN
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State | KY
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Zip | 40831-0842
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Country | US
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Telephone | 606-573-2822
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KAITLYN SKIDMORE PATEL
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Credential | DMD
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Telephone | 606-273-5427
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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 |
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License Number State |
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