| Dentrust Kentucky, Psc | |
|
2840 Bastogne Ave Fort Campbell KY 42223-5114 | |
| (267) 927-5000 | |
| Not Available |
| Full Name | Dentrust Kentucky, Psc |
|---|---|
| Speciality | Dentist |
| Location | 2840 Bastogne Ave, Fort Campbell, Kentucky |
| Authorized Official Name and Position | Amanda Clark (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 8134514503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrust Kentucky, Psc 6097 Easton Rd Pipersville PA 18947-1810 Ph: () - | Dentrust Kentucky, Psc 2840 Bastogne Ave Fort Campbell KY 42223-5114 Ph: (267) 927-5000 |
| NPI Number | 1861043499 |
|---|---|
| Provider Enumeration Date | 09/25/2019 |
| Last Update Date | 02/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861043499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |