Individual
DR. KURT R CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
566 HIGHWAY 899, HINDMAN, KY 41822-0849
(606) 785-3164
(606) 785-0107
Mailing address
566 HWY 899, HINDMAN, KY 41822
(606) 785-3164
(606) 785-0107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6629
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60066297
—
KY
Enumeration date
02/12/2007
Last updated
07/09/2007
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