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Dental Providers Dental Hygienist

Provider NPI: 1912395138

Organization Information:
Organization is not Subpart
Authorized Official:  NANCY  CREWE  DIRECTOR  859-626-4241

Practice Location:
216 BOGGS LN  RICHMOND, KY 40475-2522 US
Tel: 859-626-4502  Fax: --

Business Mailing Address:
216 BOGGS LN  RICHMOND, KY 40475-2522 US
Tel: --  Fax: --

NPI Information:
NPI: 1912395138
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 124Q00000X





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