Organization
BOURBON FAMILY DRE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH DAVIS (DIRECTOR OF REVENUE)
(859) 533-1109
Entity
Organization
Contact information
Practice address
4223 LEXINGTON RD STE A, PARIS, KY 40361-2514
(859) 988-0308
Mailing address
4223 LEXINGTON RD STE A, PARIS, KY 40361-2514
(859) 988-0308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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