| Fdc Georgetown Pllc | |
|
723 Buttermilk Pike Crescent Springs KY 41017-1304 | |
| (859) 431-3900 | |
| (859) 431-5405 |
| Full Name | Fdc Georgetown Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 723 Buttermilk Pike, Crescent Springs, Kentucky |
| Authorized Official Name and Position | Dwight Patrick Peters (CEO) |
| Authorized Official Contact | 0229520745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fdc Georgetown Pllc 1006 Leawood Dr Ste 200 Frankfort KY 40601-3523 Ph: (502) 295-2074 | Fdc Georgetown Pllc 723 Buttermilk Pike Crescent Springs KY 41017-1304 Ph: (859) 431-3900 |
| NPI Number | 1174235584 |
|---|---|
| Provider Enumeration Date | 12/16/2022 |
| Last Update Date | 12/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174235584 | NPI | - | NPPES |
| 7615 | Other | KY | LICENCE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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