Organization
VERSAILLES FAMILY DRE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH DAVIS (DIRECTOR OF REVENUE)
(859) 533-1109
Entity
Organization
Contact information
Practice address
479 LEXINGTON RD STE 103, VERSAILLES, KY 40383-1979
(859) 873-4451
Mailing address
105 SPRUCE ST, LEXINGTON, KY 40507-2109
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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