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General NPI Number Information
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NPI Number | 1770974917
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Entity Type | Organization
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Legal Business Name | SHANNON S KEMPER DMD PSC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 3340 CLAYS MILL RD STE 2
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City | LEXINGTON
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State | KY
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Zip | 40503-3488
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Country | US
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Telephone | 859-224-3200
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Fax | 859-219-1727
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Provider Business Mailing Address
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Address Line | 3340 CLAYS MILL RD STE 2
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City | LEXINGTON
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State | KY
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Zip | 40503-3488
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Country | US
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Telephone | 859-224-3200
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Fax | 859-219-1727
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANNON S KEMPER
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Credential | DMD
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Telephone | 859-224-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7372
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License Number State | KY
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