| Commonwealth Periodontics & Implant Center | |
|
1545 S Main St London KY 40741-2071 | |
| (606) 878-1971 | |
| (606) 864-8774 |
| Full Name | Commonwealth Periodontics & Implant Center |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1545 S Main St, London, Kentucky |
| Authorized Official Name and Position | Krista Paul (FINANCIAL COORDINATOR) |
| Authorized Official Contact | 6068781971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Periodontics & Implant Center 1545 S Main St London KY 40741-2071 Ph: (606) 878-1971 | Commonwealth Periodontics & Implant Center 1545 S Main St London KY 40741-2071 Ph: (606) 878-1971 |
| NPI Number | 1053767053 |
|---|---|
| Provider Enumeration Date | 05/09/2016 |
| Last Update Date | 05/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053767053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 6224 (Kentucky) | Primary |
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