Organization
WISE DENTISTRY FOR KIDS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER WISE DMD (OWNER/DENTIST)
(270) 469-1403
Entity
Organization
Contact information
Practice address
105 MEDICAL PARK DR, SUITE 1, CAMPBELLSVILLE, KY 42718-9622
(270) 469-1403
(270) 469-1405
Mailing address
105 MEDICAL PARK DRIVE, SUITE 1, CAMPBELLSVILLE, KY 42718
(270) 469-1403
(270) 469-1405
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8254
KY
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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