Individual
DR. MOHANAD AL-SABBAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-0297
(859) 323-6193
Mailing address
800 ROSE ST, D104, LEXINGTON, KY 40536-0297
(859) 323-6193
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
8148
KY
1223P0300X
Periodontics
Primary
8148
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60003340
—
KY
05
—
9177550
—
KY
Enumeration date
09/22/2006
Last updated
08/09/2019
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