MEDICARE: ARROW DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1023639879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARROW DENTAL PLLC

Provider Business Mailing Address
First Line	:	105 SPRUCE ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40507-2109
Country	:	US
Telephone Number	:	859-300-3916
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 MERIDIAN WAY STE 2
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2881
Country	:	US
Telephone Number	:	859-626-1810
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES GREGORY WHITE
Credential	:
Telephone Number	:	859-300-3916

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	05/04/2020

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