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General NPI Number Information
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NPI Number | 1841323268
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Entity Type | Organization
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Legal Business Name | JOSEPH GORMLEY DENTAL ASSOC PLLC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 7348 US HIGHWAY 42 SUITE 102
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City | FLORENCE
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State | KY
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Zip | 41042-5560
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Country | US
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Telephone | 859-283-5775
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Fax | 859-283-0017
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Provider Business Mailing Address
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Address Line | 7348 US HIGHWAY 42 SUITE 102
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City | FLORENCE
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State | KY
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Zip | 41042-5560
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Country | US
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Telephone | 859-283-5775
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Fax | 859-283-0017
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JOSEPH JOHN GORMLEY III
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Credential | DMD
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Telephone | 859-283-5775
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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 | 4002
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License Number State | KY
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