Individual
BREACYA WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 774-4401
Mailing address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 774-4401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7009
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60070091
—
KY
Enumeration date
12/06/2006
Last updated
11/26/2013
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