# KY DENTAL PROFESSIONALS II PSC

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

## Provider details

- **NPI number:** 1851830723
- **Authorized official:** KATIE WORKMAN (ANALYST, REVENUE CYCLE MANAGEMENT)
- **Authorized official phone:** (440) 241-1931

## Contact information

- **Practice address:** 1836 BROADWAY ST, PADUCAH, KY 42001-2708
- **Practice address phone:** (270) 442-0256
- **Practice address fax:** (270) 442-8730
- **Mailing address:** PO BOX 306208, NASHVILLE, TN 37230-6208
- **Mailing address phone:** (615) 620-5990
- **Mailing address fax:** (888) 702-3012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 02/13/2017
- **Last updated:** 12/03/2018