# DR. MARYLOU S HEAD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1780799908
- **Gender:** F
- **Credential:** D.M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4853 | KY | — |
| 1223G0001X | General Practice Dentistry | 4853 | KY | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 04/27/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 45003753 | — | KY |
| 05 | — | 60048535 | — | KY |