Individual
MS. VIRGINIA BROOKE FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1401 MADISON AVE, COVINGTON, KY 41011-3313
(859) 655-6100
(859) 655-6179
Mailing address
215 E 11TH ST, NEWPORT, KY 41071-2203
(859) 655-6100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.24774
OH
122300000X
Dentist
Primary
9747
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100410240
—
KY
Enumeration date
06/02/2016
Last updated
03/15/2021
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