Individual
PRATISHTHA MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BDS, MDS, MS
Contact information
Practice address
UK COLLEGE OF DENTISTRY 800 ROSE STREET, LEXINGTON, KY 40536-0001
(859) 323-3368
Mailing address
UK COLLEGE OF DENTISTRY 800 ROSE STREET, LEXINGTON, KY 40536-0001
(859) 323-3368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9684
KY
1223P0300X
Periodontics
9684
KY
1223X2210X
Orofacial Pain Dentistry
Primary
9684
KY
Other
Enumeration date
06/07/2019
Last updated
07/20/2020
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