Organization
COMMUNITY CARE OF KENTUCKY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLEN WHITMORE B.S. (CREDENTIALING MANAGER)
(256) 241-1698
Entity
Organization
Contact information
Practice address
267 SLICKBACK RD, BENTON, KY 42025-7629
(270) 527-1496
(270) 527-5321
Mailing address
PO BOX 2369, ANNISTON, AL 36202-2369
(256) 241-3965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/02/2014
Last updated
07/18/2014
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