| Bellefonte Family Dental Care, Psc | |
|
1592 Diederich Blvd Russell KY 41169-1676 | |
| (606) 836-9962 | |
| (606) 836-4668 |
| Full Name | Bellefonte Family Dental Care, Psc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1592 Diederich Blvd, Russell, Kentucky |
| Authorized Official Name and Position | Lisa Renee Dean (OWNER) |
| Authorized Official Contact | 6068369962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellefonte Family Dental Care, Psc 1592 Diederich Blvd Russell KY 41169-1676 Ph: (606) 836-9962 | Bellefonte Family Dental Care, Psc 1592 Diederich Blvd Russell KY 41169-1676 Ph: (606) 836-9962 |
| NPI Number | 1285910406 |
|---|---|
| Provider Enumeration Date | 11/02/2011 |
| Last Update Date | 11/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285910406 | NPI | - | NPPES |
| 60068905 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6890 (Kentucky) | Primary |