# COMMUNITY CARE OF KENTUCKY INC.

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

## Provider details

- **NPI number:** 1407262181
- **Authorized official:** MRS. MARLEN WHITMORE B.S. (CREDENTIALING MANAGER)
- **Authorized official phone:** (256) 241-1698

## Contact information

- **Practice address:** 267 SLICKBACK RD, BENTON, KY 42025-7629
- **Practice address phone:** (270) 527-1496
- **Practice address fax:** (270) 527-5321
- **Mailing address:** PO BOX 2369, ANNISTON, AL 36202-2369
- **Mailing address phone:** (256) 241-3965

## Taxonomy

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

## Other

- **Enumeration date:** 07/02/2014
- **Last updated:** 07/18/2014