# OWENSBORO-DAVIESS COUNTY REGIONAL DENTAL CLINIC INC

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

## Provider details

- **NPI number:** 1386874311
- **Authorized official:** BRANDON TAYLOR DMD (CLINICAL DIRECTOR)
- **Authorized official phone:** (270) 691-6205

## Contact information

- **Practice address:** 2315 MAYFAIR DR, SUITE 32, OWENSBORO, KY 42301-4557
- **Practice address phone:** (270) 691-6205
- **Mailing address:** 2315 MAYFAIR DR, SUITE 32, OWENSBORO, KY 42301-4557
- **Mailing address phone:** (270) 691-6205

## Taxonomy

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

## Other

- **Enumeration date:** 07/24/2009
- **Last updated:** 06/22/2012