# ISGRIGG FAMIILY DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1619161825
- **Authorized official:** NITA S ISGRIGG (OWNER)
- **Authorized official phone:** (502) 348-3119

## Contact information

- **Practice address:** 101 MANOR AVE, SUITE 103, BARDSTOWN, KY 40004-2298
- **Practice address phone:** (502) 348-3119
- **Mailing address:** 101 MANOR AVE, SUITE 103, BARDSTOWN, KY 40004-2298
- **Mailing address phone:** (502) 348-3119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7359 | KY | Yes |

## Other

- **Enumeration date:** 08/30/2007
- **Last updated:** 08/30/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 60073590 | — | KY |