| Kdg Kentucky 4 | |
|
105 Eminence Ter Eminence KY 40019-1145 | |
| (812) 523-1860 | |
| Not Available |
| Full Name | Kdg Kentucky 4 |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 105 Eminence Ter, Eminence, Kentucky |
| Authorized Official Name and Position | Adirnne Nicholson (OFFICE MANAGER) |
| Authorized Official Contact | 8125231860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kdg Kentucky 4 105 Eminence Ter Eminence KY 40019-1145 Ph: () - | Kdg Kentucky 4 105 Eminence Ter Eminence KY 40019-1145 Ph: (812) 523-1860 |
| NPI Number | 1295226496 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295226496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |