Organization
DENTISTRY FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANNE RICHARDSON (MANAGER)
(859) 626-9620
Entity
Organization
Contact information
Practice address
216 FOUNTAIN COURT, SUITE 150, LEXINGTON, KY 40509
(859) 543-2242
(859) 685-0115
Mailing address
216 FOUNTAIN COURT, SUITE 150, LEXINGTON, KY 40509
(859) 543-2242
(859) 685-0115
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4500313400
—
KY
Enumeration date
02/16/2007
Last updated
06/27/2011
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