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Organization
COMMUNITY CARE OF KENTUCKY, INC.
Active
Organization
COMMUNITY CARE OF KENTUCKY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLEN WHITMORE B.S. (CREDENTIALING MANAGER)
(256) 241-3965
Entity
Organization
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 681-0514
(270) 681-5315
Mailing address
PO BOX 2369, ANNISTON, AL 36202-2369
(256) 241-3965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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