| Pediatric Dental Center | |
|
5495 N Bend Rd Suite 102 Burlington KY 41005-9378 | |
| (859) 534-5640 | |
| (859) 534-5922 |
| Full Name | Pediatric Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5495 N Bend Rd, Burlington, Kentucky |
| Authorized Official Name and Position | Eric M Soper (OWNER) |
| Authorized Official Contact | 8595345640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Center 5495 N Bend Rd Suite 102 Burlington KY 41005-9378 Ph: (859) 534-5640 | Pediatric Dental Center 5495 N Bend Rd Suite 102 Burlington KY 41005-9378 Ph: (859) 534-5640 |
| NPI Number | 1386921526 |
|---|---|
| Provider Enumeration Date | 11/15/2011 |
| Last Update Date | 11/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386921526 | NPI | - | NPPES |
| 60002821 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 736 (Kentucky) | Primary |
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