Individual
DR. LAMONT RAY GHOLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
928 E BROADWAY, LOUISVILLE, KY 40204-1057
(502) 581-0015
(502) 582-2368
Mailing address
928 E BROADWAY, LOUISVILLE, KY 40204-1057
(502) 581-0015
(502) 582-2368
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4585
KY
Other
Enumeration date
04/18/2009
Last updated
04/18/2009
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