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Individual

ALVIN BRENT CHUMBLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD MSD

Contact information

Practice address
727 W CUMBERLAND GAP PKWY, SUITE D, CORBIN, KY 40701-4822
(606) 523-2000
(606) 523-2823
Mailing address
727 W CUMBERLAND GAP PKWY, SUITE D, CORBIN, KY 40701-4822
(606) 523-2000
(606) 523-2823

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
4318
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4318
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60043189
KY
05
9178567
VA
Enumeration date
04/27/2006
Last updated
08/30/2011
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