Organization
AKDM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOB FONTANA (CEO)
(315) 454-6000
Entity
Organization
Contact information
Practice address
5035 FREDERICA ST, OWENSBORO, KY 42301-7515
(270) 686-1636
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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