Organization
ISGRIGG FAMIILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NITA S ISGRIGG (OWNER)
(502) 348-3119
Entity
Organization
Contact information
Practice address
101 MANOR AVE, SUITE 103, BARDSTOWN, KY 40004-2298
(502) 348-3119
Mailing address
101 MANOR AVE, SUITE 103, BARDSTOWN, KY 40004-2298
(502) 348-3119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7359
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60073590
—
KY
Enumeration date
08/30/2007
Last updated
08/30/2007
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