Organization
FOREVER SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY DYE (PRESIDENT)
(606) 949-6971
Entity
Organization
Contact information
Practice address
6363 KENTUCKY ROUTE 1428, ALLEN, KY 41601
(606) 949-6971
(606) 949-6986
Mailing address
PO BOX 308, 6363 KENTUCKY ROUTE 1428, ALLEN, KY 41601
(606) 949-6971
(606) 949-6986
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6977
KY
1223G0001X
General Practice Dentistry
7084
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60069770
—
KY
Enumeration date
03/01/2012
Last updated
07/18/2015
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