Organization
PEDIATRIC DENTISTRY OF GEORGETOWN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER A COTTERILL D.M.D. (OWNER)
(502) 867-0451
Entity
Organization
Contact information
Practice address
101 DARBY DR STE 101, GEORGETOWN, KY 40324-8715
(502) 867-0451
(502) 867-0458
Mailing address
101 DARBY DR STE 101, GEORGETOWN, KY 40324-8715
(502) 867-0451
(502) 867-0458
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
754
KY
261QD0000X
Dental Clinic/Center
Primary
7468
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60003530
—
KY
Enumeration date
10/17/2006
Last updated
05/14/2008
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