| Pdoh Dre LLC | |
|
2517 Sir Barton Way Ste 200 Lexington KY 40509-2744 | |
| (859) 543-2456 | |
| Not Available |
| Full Name | Pdoh Dre LLC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2517 Sir Barton Way Ste 200, Lexington, Kentucky |
| Authorized Official Name and Position | James White (MANAGER) |
| Authorized Official Contact | 8595331109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pdoh Dre LLC 105 Spruce St Lexington KY 40507-2109 | Pdoh Dre LLC 2517 Sir Barton Way Ste 200 Lexington KY 40509-2744 Ph: (859) 543-2456 |
| NPI Number | 1982486346 |
|---|---|
| Provider Enumeration Date | 10/19/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982486346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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