Organization
GREATER OWENSBORO PEDIATRIC DENTISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE DICKENS DMD (PRESIDENT)
(270) 683-7114
Entity
Organization
Contact information
Practice address
3817 FAIRVIEW DR, OWENSBORO, KY 42303-2117
(270) 683-7114
Mailing address
3817 FAIRVIEW DR, OWENSBORO, KY 42303-2117
(270) 683-7114
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
02/14/2023
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