Individual
CASEY GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3603 INDIANA AVE, FORT CAMPBELL, KY 42223-5803
(270) 798-3544
(270) 956-0266
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8751
(270) 956-0266
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4531
KY
Other
Enumeration date
06/21/2016
Last updated
06/07/2022
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