Organization
FDC GEORGETOWN PLLC
Active
Other names
Dilts Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT PATRICK PETERS MD (CEO)
(022) 952-0745
Entity
Organization
Contact information
Practice address
723 BUTTERMILK PIKE, CRESCENT SPRINGS, KY 41017-1304
(859) 431-3900
(859) 431-5405
Mailing address
1006 LEAWOOD DR STE 200, FRANKFORT, KY 40601-3523
(502) 295-2074
(502) 875-5567
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7615
LICENCE NUMBER
KY
Enumeration date
12/16/2022
Last updated
12/16/2022
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