Individual
MR. MICHAEL WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
828 SOUTH MAIN STREET, LONDON, KY 40741
(606) 878-7251
(606) 878-1285
Mailing address
828 SOUTH MAIN STREET, LONDON, KY 40741
(606) 878-7251
(606) 878-1285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6869
KY
1223G0001X
General Practice Dentistry
Primary
6869
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60068699
—
KY
Enumeration date
03/06/2007
Last updated
02/02/2012
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