Individual
KENNETH GRANT BALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
155 OLDE TOWNE BLVD, BOWLING GREEN, KY 42103
(270) 715-2978
(270) 715-2985
Mailing address
155 OLDE TOWNE BLVD, BOWLING GREEN, KY 42103
(270) 715-2978
(270) 715-2985
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7120
SC
122300000X
Dentist
9085
KY
1223G0001X
General Practice Dentistry
Primary
9058
KY
Other
Enumeration date
04/25/2011
Last updated
10/26/2022
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