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Individual

DR. MICHAEL BRENT MAGGARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.D

Contact information

Practice address
118 W 8TH ST, LONDON, KY 40741-1714
(606) 877-1900
(606) 877-1755
Mailing address
118 W 8TH ST, LONDON, KY 40741-1714
(606) 877-1900
(606) 877-1755

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7280
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60006566
KY
Enumeration date
02/20/2007
Last updated
07/08/2007
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