| Maysville Pediatric Dental Center | |
|
1415 Kenton Pointe Way Maysville KY 41056-1174 | |
| (606) 934-8004 | |
| Not Available |
| Full Name | Maysville Pediatric Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1415 Kenton Pointe Way, Maysville, Kentucky |
| Authorized Official Name and Position | Mackenzie Lucas (OWNER/DENTIST) |
| Authorized Official Contact | 6069348004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maysville Pediatric Dental Center 1415 Kenton Pointe Way Maysville KY 41056-1174 Ph: (606) 934-8004 | Maysville Pediatric Dental Center 1415 Kenton Pointe Way Maysville KY 41056-1174 Ph: (606) 934-8004 |
| NPI Number | 1750027413 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 05/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750027413 | NPI | - | NPPES |
| 1821520024 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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