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Organization
DENTAL PROFESSIONAL OF KENTUCKY PSC
Active
Organization
DENTAL PROFESSIONAL OF KENTUCKY PSC
Active
Other names
Creative Smiles - Georgetown
Organization subpart
No
Provider details
NPI number
Authorized official
AMY M KROEGER (INS COOD)
(217) 540-5100
Entity
Organization
Contact information
Practice address
240 BLOSSOM PARK DR, SUITE 1, GEORGETOWN, KY 40324-9079
(502) 570-8778
(502) 570-8878
Mailing address
240 BLOSSOM PARK DR, SUITE 1, GEORGETOWN, KY 40324-9079
(502) 570-8778
(502) 570-8878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/19/2006
Last updated
08/22/2020
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