| Dayspring Dental | |
|
640 W Highway 92 Ste 3 Williamsburg KY 40769-1936 | |
| (606) 765-6080 | |
| (606) 549-2855 |
| Full Name | Dayspring Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 640 W Highway 92 Ste 3, Williamsburg, Kentucky |
| Authorized Official Name and Position | John David Harris (CREDENTIALING) |
| Authorized Official Contact | 4237848492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dayspring Dental Po Box 540 Jellico TN 37762-0540 Ph: (423) 784-8492 | Dayspring Dental 640 W Highway 92 Ste 3 Williamsburg KY 40769-1936 Ph: (606) 765-6080 |
| NPI Number | 1841764271 |
|---|---|
| Provider Enumeration Date | 01/18/2019 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841764271 | NPI | - | NPPES |
| 10107 | Other | KY | STATE LICENSE |
| Q055857 | Medicaid | TN | |
| 31000946 | Medicaid | KY | |
| 7100553680 | Medicaid | KY | |
| 9042 | Other | KY | STATE LICENSE |
| 7100191350 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
| 1223G0001X | Dentist - General Practice | (NU) | Secondary |
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