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General NPI Number Information
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NPI Number | 1881710820
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Entity Type | Organization
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Legal Business Name | DENNIS ALAN HISE, PSC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1028 N COLLEGE ST
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City | HARRODSBURG
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State | KY
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Zip | 40330-2227
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Country | US
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Telephone | 859-734-5437
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Fax | 859-734-5437
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Provider Business Mailing Address
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Address Line | PO BOX 104 1028 NORTH COLLEGE ST.
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City | HARRODSBURG
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State | KY
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Zip | 40330-0104
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Country | US
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Telephone | 859-734-5437
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Fax | 859-734-5437
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Authorized Official
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Title or Position | SECRETARY,TREASURER,OFFICE MANAGER
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Name | MRS. DEBORAH D HISE
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Credential | RDH, BHS
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Telephone | 859-734-5437
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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 | 4264
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License Number State | KY
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