| Park Hills Dentistry | |
|
3122 Custer Dr Lexington KY 40517-4000 | |
| (859) 273-5020 | |
| (859) 245-2219 |
| Full Name | Park Hills Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 3122 Custer Dr, Lexington, Kentucky |
| Authorized Official Name and Position | Jinyoung Kim (OWNER) |
| Authorized Official Contact | 8592735020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Hills Dentistry 3122 Custer Dr Lexington KY 40517-4000 Ph: (859) 273-5020 | Park Hills Dentistry 3122 Custer Dr Lexington KY 40517-4000 Ph: (859) 273-5020 |
| NPI Number | 1306499082 |
|---|---|
| Provider Enumeration Date | 07/22/2019 |
| Last Update Date | 01/18/2021 |
| Certification Date | 01/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306499082 | NPI | - | NPPES |
| 7100482030 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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