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Organization

BOURBON FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARION SUSANNE KOLLAHSADEH DMD (DENTIST OWNER)
(859) 988-0308
Entity
Organization

Contact information

Practice address
4223 A LEXINGTON RD, PARIS, KY 40361
(859) 988-0308
(859) 988-0310
Mailing address
4223 A LEXINGTON RD, PARIS, KY 40361
(859) 988-0308
(859) 988-0310

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7770KY
KY

Other

Enumeration date
12/28/2006
Last updated
08/22/2020
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