# PROSPECT DENTAL PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sara Cummins Aesthetic & Implant Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508637620
- **Authorized official:** JENNY GARCIA-ROCHA (SR CREDENTIALING TEAM LEAD)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 9207 US HIGHWAY 42 STE F, PROSPECT, KY 40059-9391
- **Practice address phone:** (502) 228-4700
- **Mailing address:** 9207 US HIGHWAY 42 STE F, PROSPECT, KY 40059-9391
- **Mailing address phone:** (502) 228-4700

## Taxonomy

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

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 01/09/2024