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General NPI Number Information
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NPI Number | 1609684406
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Entity Type | Organization
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Legal Business Name | KING & MILES FAMILY DENTISTRY, LLC
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 2038 LINCOLN AVE
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City | EVANSVILLE
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State | IN
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Zip | 47714-1561
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Country | US
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Telephone | 812-473-1128
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Fax | 812-473-3850
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Provider Business Mailing Address
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Address Line | 2038 LINCOLN AVE
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City | EVANSVILLE
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State | IN
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Zip | 47714-1561
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Country | US
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Telephone | 812-473-1128
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Fax | 812-473-3850
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JOSEPH KING
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Credential | DDS
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Telephone | 812-430-6023
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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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