Organization
MT WASHINGTON FAMILY DENTISTRY NITA S ISGRIGG DMD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NITA S ISGRIGG (OWNER)
(502) 538-3434
Entity
Organization
Contact information
Practice address
110 VILLAGE LN, MT WASHINGTON, KY 40047-7658
(502) 538-3434
Mailing address
110 VILLAGE LN, MT WASHINGTON, KY 40047
(502) 538-3434
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7359
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60073590
—
KY
Enumeration date
09/10/2007
Last updated
09/10/2007
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