Organization
BOONEVILLE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WYNN GAY D.M.D. (OWNER)
(606) 723-1000
Entity
Organization
Contact information
Practice address
706 NORTH COURTHOUSE SQUARE, BOONEVILLE, KY 41314
(606) 723-1000
(606) 723-1039
Mailing address
PO BOX 1167, BOONEVILLE, KY 41314-1167
(606) 723-1000
(606) 723-1039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7138
KY
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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