Community Care of Kentucky, INC
NPI #1053799080 in Madisonville, Kentucky
Provider Information
- NPI Number
- 1053799080
- Entity Type
- Organization
- Organization Name
- Community Care of Kentucky, INC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 11, 2015
- Last Updated
- May 7, 2018
Practice Location
- Address
- 1175 S MAIN ST STE 4
- City
- Madisonville
- State
- Kentucky
- ZIP Code
- 42431-3337
- Phone
- (270) 383-5511
Authorized Official
- Name
- JENELL STUMP
- Title
- MANAGER, LICENSING & CREDENTIALING
- Phone
- (629) 999-5006
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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