# DENNIS ALAN HISE, PSC

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

## Provider details

- **NPI number:** 1881710820
- **Authorized official:** MRS. DEBORAH D HISE RDH, BHS (SECRETARY,TREASURER,OFFICE MANAGER)
- **Authorized official phone:** (859) 734-5437

## Contact information

- **Practice address:** 1028 N COLLEGE ST, HARRODSBURG, KY 40330-2227
- **Practice address phone:** (859) 734-5437
- **Practice address fax:** (859) 734-5437
- **Mailing address:** PO BOX 104, 1028 NORTH COLLEGE ST., HARRODSBURG, KY 40330-0104
- **Mailing address phone:** (859) 734-5437
- **Mailing address fax:** (859) 734-5437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4264 | KY | Yes |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6194092000 | — | KY |