Organization
EDP OF KENTUCKY PC
Active
Parent organization
EDP OF KENTUCKY PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDP OF KENTUCKY PC
Authorized official
ROSEANNE BRUNENKANT (DIRECTOR OF INTEGRATIONS)
(312) 937-3619
Entity
Organization
Contact information
Practice address
342 STARLITE DR, HENDERSON, KY 42420-6102
(270) 826-1414
Mailing address
141 W JACKSON BLVD STE 210, CHICAGO, IL 60604-3048
(312) 800-1270
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
09/16/2019
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