Organization
THOMAS R. VIVIAN DMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS VIVIAN DMD (DR/OWNER)
(502) 420-2480
Entity
Organization
Contact information
Practice address
10515 MEETING ST, 104, PROSPECT, KY 40059-6523
(502) 420-2480
(502) 420-2891
Mailing address
10515 MEETING ST, 104, PROSPECT, KY 40059-6523
(502) 420-2480
(502) 420-2891
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8638
KY
Other
Enumeration date
05/11/2010
Last updated
05/11/2010
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