# BARBOURVILLE FAMILY DENTAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003961905
- **Authorized official:** DR. A J SMITH JR. DMD (DENTIST)
- **Authorized official phone:** (606) 545-7715

## Contact information

- **Practice address:** 201 N ALLISON AVE, BARBOURVILLE, KY 40906-1336
- **Practice address phone:** (606) 545-7715
- **Practice address fax:** (606) 546-2337
- **Mailing address:** 201 N ALLISON AVE, BARBOURVILLE, KY 40906-1336
- **Mailing address phone:** (606) 545-7715
- **Mailing address fax:** (606) 546-2337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7386 | KY | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1341350 | UNITED CONCORDIA | KY |
| 05 | — | 60000924 | — | KY |