| Carlisle Family Dental | |
|
110 S Locust St Carlisle KY 40311-1123 | |
| (859) 289-5418 | |
| (859) 289-8153 |
| Full Name | Carlisle Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 110 S Locust St, Carlisle, Kentucky |
| Authorized Official Name and Position | Brandon Ira Allen (OWNER/DENTIST) |
| Authorized Official Contact | 8592277290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlisle Family Dental 110 S Locust St Carlisle KY 40311-1123 Ph: (859) 289-5418 | Carlisle Family Dental 110 S Locust St Carlisle KY 40311-1123 Ph: (859) 289-5418 |
| NPI Number | 1245505908 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245505908 | NPI | - | NPPES |
| 7100053320 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8056 (Kentucky) | Primary |
Carlisle Family Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 S Locust St, Carlisle, KY 40311 Phone: 859-289-5418 | |
Mortenson Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 N. Locust St, Carlisle, KY 40311 Phone: 859-289-5418 Fax: 859-289-8153 |