# EDGEWOOD DENTAL CARE PSC

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

## Provider details

- **NPI number:** 1841693033
- **Authorized official:** DR. KEVIN MCMAHON DMD (DENTIST)
- **Authorized official phone:** (859) 331-3400

## Contact information

- **Practice address:** 155 BARNWOOD DRIVE, STE 1, EDGEWOOD, KY 41017
- **Practice address phone:** (859) 331-3400
- **Practice address fax:** (859) 331-6429
- **Mailing address:** 155 BARNWOOD DR, SUITE 1, EDGEWOOD, KY 41017-2585
- **Mailing address phone:** (859) 331-3400
- **Mailing address fax:** (859) 331-6429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4333 | KY | — |
| 1223G0001X | General Practice Dentistry | 6007 | KY | Yes |
| 1223G0001X | General Practice Dentistry | 8628 | KY | — |
| 1223G0001X | General Practice Dentistry | 9229 | KY | — |

## Other

- **Enumeration date:** 10/01/2014
- **Last updated:** 10/01/2014