Organization
COMMUNITY CARE OF KENTUCKY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLEN WHITMORE B.S. (CREDENTIALING MANAGER)
(256) 241-3965
Entity
Organization
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 681-0514
(270) 681-5315
Mailing address
PO BOX 2369, ANNISTON, AL 36202-2369
(256) 241-3965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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