# COMMONWEALTH HEALTH FREE CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE DENTAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114169661
- **Authorized official:** RONALD G. SOWELL (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (270) 781-9765

## Contact information

- **Practice address:** 740 E 10TH AVE, BOWLING GREEN, KY 42101-2318
- **Practice address phone:** (270) 781-9765
- **Practice address fax:** (270) 782-6461
- **Mailing address:** PO BOX 9577, BOWLING GREEN, KY 42102-9577
- **Mailing address phone:** (270) 745-1467
- **Mailing address fax:** (270) 745-1156

## Taxonomy

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

## Other

- **Enumeration date:** 03/30/2009
- **Last updated:** 03/30/2009