Organization
IDENTITY DENTAL STUDIO, PLLC
Active
Parent organization
IDENTITY DENTAL STUDIO, PLLC
Other names
iDS Smile Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDENTITY DENTAL STUDIO, PLLC
Authorized official
BRANDON M STAPLETON DMD, MSD (DENTIST/OWNER)
(859) 287-2484
Entity
Organization
Contact information
Practice address
541 DARBY CREEK ROAD, STE 190, LEXINGTON, KY 40509
(859) 287-2484
(859) 287-2484
Mailing address
541 DARBY CREEK ROAD, STE 190, LEXINGTON, KY 40509
(859) 287-2484
(859) 287-2484
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
9038
KY
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
01/16/2020
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