Individual
DR. KELLY GOODPASTER WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
535 WELLINGTON WAY STE 120, LEXINGTON, KY 40503-1387
(859) 630-1315
Mailing address
416 RIDGEWAY RD, LEXINGTON, KY 40502-2344
(859) 630-1315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10353
KY
Other
Enumeration date
08/01/2014
Last updated
08/14/2019
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