| The Dentist Office Psc | |
|
1144 S Mayo Trail Suite 101 Pikeville KY 41501 | |
| (606) 433-0033 | |
| (606) 433-0990 |
| Full Name | The Dentist Office Psc |
|---|---|
| Speciality | Dentist |
| Location | 1144 S Mayo Trail, Pikeville, Kentucky |
| Authorized Official Name and Position | Chonda Harris Whitfield (PRESIDENT) |
| Authorized Official Contact | 6064330033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dentist Office Psc 1144 S Mayo Trail Suite 101 Pikeville KY 41501 Ph: (606) 433-0033 | The Dentist Office Psc 1144 S Mayo Trail Suite 101 Pikeville KY 41501 Ph: (606) 433-0033 |
| NPI Number | 1114085982 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114085982 | NPI | - | NPPES |
| 61900312 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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