Ky Dental Professional, Psc

NPI #1013160522 in Lexington, Kentucky

Provider Information

NPI Number: 1013160522
Entity Type: Organization
Organization Name: Ky Dental Professional, Psc
Primary Specialty: Dentist
Enumeration Date: Oct 28, 2008
Last Updated: Jan 21, 2009

Practice Location

Address: 1330 S BROADWAY
City: Lexington
State: Kentucky
ZIP Code: 40504-2737
Phone: (859) 252-5220

Authorized Official

Name: MRS. CARON C CARBONE
Title: OFFICE ADMINISTRATOR
Phone: (859) 252-5220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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