# KENTUCKY DENTAL PROFESSIONALS PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENTUCKY DENTAL PROFESSIONALS PSC
- **Other names:** Buttermilk Family and Cosmetic Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811162357
- **Legal business name:** KENTUCKY DENTAL PROFESSIONALS PSC
- **Authorized official:** AMY KROEGER (INS COORD)
- **Authorized official phone:** (217) 540-5100

## Contact information

- **Practice address:** 618 BUTTERMILK PIKE, CRESCENT SPRINGS, KY 41017-1302
- **Practice address phone:** (859) 344-9222
- **Practice address fax:** (859) 344-1490
- **Mailing address:** 618 BUTTERMILK PIKE, CRESCENT SPRINGS, KY 41017-1302
- **Mailing address phone:** (859) 344-9222
- **Mailing address fax:** (859) 344-1490

## Taxonomy

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

## Other

- **Enumeration date:** 04/25/2008
- **Last updated:** 10/24/2019