Organization
FAITH HEALTHCARE INC
Active
Other names
Faith Dental of Monticello
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN ROY ANTLE (CEO)
(606) 425-5768
Entity
Organization
Contact information
Practice address
1225 N MAIN ST, MONTICELLO, KY 42633-1902
(606) 340-0740
(606) 340-0742
Mailing address
521 CRANE RD, SOMERSET, KY 42501-9503
(606) 425-5768
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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