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Organization

ANSLEY H DEPP PLLC

Active
Other names
DENTAL BLU
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANSLEY H DEPP DMD (OWNER)
(859) 442-8200
Entity
Organization

Contact information

Practice address
2600 ALEXANDRIA PIKE, HIGHLAND HEIGHTS, KY 41076-1590
(859) 442-8200
(859) 442-9555
Mailing address
2600 ALEXANDRIA PIKE, HIGHLAND HEIGHTS, KY 41076-1590
(859) 442-8200
(859) 442-9555

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6751
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7519370001
MEDICARE PTAN
KY
Enumeration date
02/10/2016
Last updated
07/26/2016
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