MEDICARE: ALAN D WARD DMD PSC

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	122300000X	Dentist	4367	KY

General Provider Information

NPI Number	:	1083871289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN D WARD DMD PSC

Provider Business Mailing Address
First Line	:	1804 BRYAN STATION RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-2232
Country	:	US
Telephone Number	:	859-299-0441
Fax Number	:

Provider Business Practice Location Address
First Line	:	1804 BRYAN STATION RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-2232
Country	:	US
Telephone Number	:	859-299-0441
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALAN D WARD
Credential	:	DMD
Telephone Number	:	859-299-0441

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/16/2008

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