# DR. TRACEY BUTLER ROSS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053407965
- **Gender:** F
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6627 | KY | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2446642 | — | OH |
| 05 | — | 45002664 | — | KY |
| 05 | — | 60001856 | — | KY |