Individual
GRANIT DERVISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 HIGHLAND PARK DR, RICHMOND, KY 40475-3839
(859) 626-7700
Mailing address
401 HIGHLAND PARK DR, RICHMOND, KY 40475-3839
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10902
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2022
Last updated
07/23/2024
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