Organization
LAKE CUMBERLAND DISTRICT HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN CRABTREE (EXECUTIVE DIRECTOR)
(606) 678-4761
Entity
Organization
Contact information
Practice address
500 BOURNE AVE, SOMERSET, KY 42501-1916
(606) 678-4761
Mailing address
500 BOURNE AVE, SOMERSET, KY 42501-1916
(606) 678-4761
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639153034
NPI # OF DENTAL PROVIDER
KY
05
—
6190128600
—
KY
Enumeration date
12/16/2008
Last updated
12/16/2008
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