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Individual

DR. KIMBERLY S HANSFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
130 EVERGREEN RD, SUITE 100, MIDDLETOWN, KY 40243-1489
(502) 410-1710
(502) 244-1244
Mailing address
130 EVERGREEN RD, SUITE 100, MIDDLETOWN, KY 40243-1489
(502) 410-1710
(502) 245-5021

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
7469
KY
1223P0221X
Pediatric Dentistry
Primary
7469
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60002474
KY
Enumeration date
09/03/2006
Last updated
09/21/2012
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