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Organization
FDC GEORGETOWN PLLC
Active
Organization
FDC GEORGETOWN PLLC
Active
Other names
Dilts Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT PATRICK PETERS MD (CEO)
(022) 952-0745
Entity
Organization
Contact information
Practice address
723 BUTTERMILK PIKE, CRESCENT SPRINGS, KY 41017-1304
(859) 431-3900
(859) 431-5405
Mailing address
1006 LEAWOOD DR STE 200, FRANKFORT, KY 40601-3523
(502) 295-2074
(502) 875-5567
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7615
LICENCE NUMBER
KY
Enumeration date
12/16/2022
Last updated
12/16/2022
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