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General NPI Number Information
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NPI Number | 1831292499
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Entity Type | Organization
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Legal Business Name | BRUMMETT COSMETIC AND FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 1225 N MAIN ST
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City | MONTICELLO
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State | KY
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Zip | 42633-1902
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Country | US
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Telephone | 606-340-0740
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Fax | 606-340-0742
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Provider Business Mailing Address
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Address Line | 1225 N MAIN ST
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City | MONTICELLO
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State | KY
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Zip | 42633-1902
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Country | US
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Telephone | 606-340-0740
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Fax | 606-340-0742
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL JAMES BRUMMETT
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Credential | DMD
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Telephone | 606-340-0740
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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 | 8228
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8228
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License Number State | KY
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