Thomas R. Vivian Dmd Pllc

NPI #1649598921 in Prospect, Kentucky

Provider Information

NPI Number: 1649598921
Entity Type: Organization
Organization Name: Thomas R. Vivian Dmd Pllc
Primary Specialty: Dentist
Enumeration Date: May 11, 2010
Last Updated: May 11, 2010

Practice Location

Address: 10515 MEETING ST
Address 2: 104
City: Prospect
State: Kentucky
ZIP Code: 40059-6523
Phone: (502) 420-2480

Authorized Official

Name: DR. THOMAS VIVIAN, DMD
Title: DR/OWNER
Phone: (502) 420-2480

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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