| Clinton Dental Clinic,inc. | |
|
201 S Washington St Clinton KY 42031-1440 | |
| (270) 653-4600 | |
| (270) 653-2778 |
| Full Name | Clinton Dental Clinic,inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 201 S Washington St, Clinton, Kentucky |
| Authorized Official Name and Position | Rickey Allan Canty (OWNER-DENTIST) |
| Authorized Official Contact | 2706534600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton Dental Clinic,inc. Po Box 217 Clinton KY 42031-0217 Ph: (270) 653-4600 | Clinton Dental Clinic,inc. 201 S Washington St Clinton KY 42031-1440 Ph: (270) 653-4600 |
| NPI Number | 1073679866 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 03/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073679866 | NPI | - | NPPES |
| 6004384100 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4384 (Kentucky) | Primary |