| Licking Valley Dental Associates Psc | |
|
114 S Main St Cynthiana KY 41031-1521 | |
| (859) 234-3323 | |
| (859) 234-3332 |
| Full Name | Licking Valley Dental Associates Psc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 114 S Main St, Cynthiana, Kentucky |
| Authorized Official Name and Position | James Stephen Clyde (PRESIDENT) |
| Authorized Official Contact | 8592343323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Valley Dental Associates Psc 114 S Main St Cynthiana KY 41031-1521 Ph: (859) 234-3323 | Licking Valley Dental Associates Psc 114 S Main St Cynthiana KY 41031-1521 Ph: (859) 234-3323 |
| NPI Number | 1982769154 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982769154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4932 (Kentucky) | Primary |
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