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General NPI Number Information
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NPI Number | 1942755905
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Entity Type | Organization
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Legal Business Name | BARTH FAMILY DENTISTRY P.S.C.
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 1821 FLORENCE PIKE STE 2
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City | BURLINGTON
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State | KY
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Zip | 41005-7942
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Country | US
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Telephone | 859-689-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 FLORENCE PIKE STE 2
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City | BURLINGTON
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State | KY
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Zip | 41005-7942
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Country | US
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Telephone | 859-689-7700
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Fax |
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Authorized Official
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Title or Position | DENTIST AND OWNER
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Name | DR. CHARITY ANNE BARTH OMOSIVWE
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Credential | D.M.D., R.D.H
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Telephone | 859-689-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7886
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License Number State | KY
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