MEDICARE: KRISTEN FOLEY DMD

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	1223G0001X	General Practice Dentistry	9746	KY

General Provider Information

NPI Number	:	1407204324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN FOLEY DMD

Provider Business Mailing Address
First Line	:	311 RADIO PARK DR STE B
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2399
Country	:	US
Telephone Number	:	859-623-3818
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 RADIO PARK DR STE B
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2399
Country	:	US
Telephone Number	:	859-623-3818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2016
Last Update Date	:	09/24/2019

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