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Organization

KENTUCKY DENTAL PROFESSIONALS, PSC

Active
Parent organization
KENTUCKY DENTAL PROFESSIONALS, PSC
Other names
Northwest Kentucky Dental Centre
Organization subpart
Yes

Provider details

NPI number
Legal business name
KENTUCKY DENTAL PROFESSIONALS, PSC
Authorized official
PAM HARDIEK (INSURANCE/CREDENTIALING)
(270) 827-4534
Entity
Organization

Contact information

Practice address
616 BARRETT BLVD, HENDERSON, KY 42420-2620
(270) 827-4534
(270) 827-4503
Mailing address
616 BARRETT BLVD, HENDERSON, KY 42420-2620
(270) 827-4534
(270) 827-4503

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
09/21/2010
Last updated
09/21/2010
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