Individual
DR. JULIAN MACON DISMUKES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
BLDG 2441 21ST ST, USA DENTAC, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Mailing address
BLDG 2441 21ST ST, USA DENTAC, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4047
KY
1223G0001X
General Practice Dentistry
Primary
4047
KY
Other
Enumeration date
01/17/2006
Last updated
07/13/2026
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