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General NPI Number Information
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NPI Number | 1962121384
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Entity Type | Individual
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Provider Name | JACQULINE DANIELLE CECIL DMD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 101 QUAIL DR
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City | CYNTHIANA
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State | KY
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Zip | 41031-9482
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Country | US
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Telephone | 859-588-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 146 LAKEVIEW DR
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City | GEORGETOWN
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State | KY
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Zip | 40324-9495
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Country | US
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Telephone | 859-588-2599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10845
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License Number State | KY
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