Organization
PROSPECT DENTAL PLC
Active
Other names
Sara Cummins Aesthetic & Implant Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (SR CREDENTIALING TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
9207 US HIGHWAY 42 STE F, PROSPECT, KY 40059-9391
(502) 228-4700
Mailing address
9207 US HIGHWAY 42 STE F, PROSPECT, KY 40059-9391
(502) 228-4700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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