# EADES FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greenville Family Dentistry PSC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154679520
- **Authorized official:** DR. WILLIAM BRYAN EADES DMD (OWNER)
- **Authorized official phone:** (270) 754-1404

## Contact information

- **Practice address:** 1603 W EVERLY BROS BLVD SUITE 2A, CENTRAL CITY, KY 42330
- **Practice address phone:** (270) 754-1404
- **Mailing address:** 1603 W EVERLY BROS BLVD SUITE 2A, CENTRAL CITY, KY 42330
- **Mailing address phone:** (270) 754-1404

## Taxonomy

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

## Other

- **Enumeration date:** 08/16/2012
- **Last updated:** 10/27/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100224230 | — | KY |