# BIG SANDY DENTAL CENTER PSC

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

## Provider details

- **NPI number:** 1235475112
- **Authorized official:** TODD A. RATLIFF DMD (PRESIDENT)
- **Authorized official phone:** (606) 509-8633

## Contact information

- **Practice address:** 180 TOWN MOUNTAIN RD STE 111, PIKEVILLE, KY 41501-1607
- **Practice address phone:** (606) 509-8633
- **Practice address fax:** (606) 509-8634
- **Mailing address:** 180 TOWN MOUNTAIN RD STE 111, PIKEVILLE, KY 41501-1607
- **Mailing address phone:** (606) 509-8633
- **Mailing address fax:** (606) 509-8634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2012
- **Last updated:** 12/20/2012