| Pediatric Dentistry Of Georgetown, Pllc | |
|
101 Darby Dr Ste 101 Georgetown KY 40324-8715 | |
| (502) 867-0451 | |
| (502) 867-0458 |
| Full Name | Pediatric Dentistry Of Georgetown, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 101 Darby Dr Ste 101, Georgetown, Kentucky |
| Authorized Official Name and Position | Christopher A Cotterill (OWNER) |
| Authorized Official Contact | 5028670451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Georgetown, Pllc 101 Darby Dr Ste 101 Georgetown KY 40324-8715 Ph: (502) 867-0451 | Pediatric Dentistry Of Georgetown, Pllc 101 Darby Dr Ste 101 Georgetown KY 40324-8715 Ph: (502) 867-0451 |
| NPI Number | 1447331509 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447331509 | NPI | - | NPPES |
| 60003530 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 754 (Kentucky) | Secondary |
| 261QD0000X | Clinic/center - Dental | 7468 (Kentucky) | Primary |
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