Individual
BRIAN MATTHEW LIXEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8614
(270) 798-8633
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8614
(270) 798-8633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020670
MI
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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