Organization
KY DENTAL PROFESSIONAL, PSC
Active
Other names
Audubon Dental & Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARON C CARBONE (OFFICE ADMINISTRATOR)
(859) 252-5220
Entity
Organization
Contact information
Practice address
1330 S BROADWAY, LEXINGTON, KY 40504-2737
(859) 252-5220
(859) 252-0405
Mailing address
1330 S BROADWAY, LEXINGTON, KY 40504-2737
(859) 252-5220
(859) 252-0405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6944
KY
Other
Enumeration date
10/28/2008
Last updated
01/21/2009
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