| Ky Dental Professional, Psc | |
|
1330 S Broadway Lexington KY 40504-2737 | |
| (859) 252-5220 | |
| (859) 252-0405 |
| Full Name | Ky Dental Professional, Psc |
|---|---|
| Speciality | Dentist |
| Location | 1330 S Broadway, Lexington, Kentucky |
| Authorized Official Name and Position | Caron C Carbone (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 8592525220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ky Dental Professional, Psc 1330 S Broadway Lexington KY 40504-2737 Ph: (859) 252-5220 | Ky Dental Professional, Psc 1330 S Broadway Lexington KY 40504-2737 Ph: (859) 252-5220 |
| NPI Number | 1013160522 |
|---|---|
| Provider Enumeration Date | 10/28/2008 |
| Last Update Date | 01/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013160522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6944 (Kentucky) | Primary |
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