Individual
DR. MANSFIELD DIXON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
121 W VIRGINIA AVE, PINEVILLE, KY 40977-1600
(606) 337-3034
(606) 337-5305
Mailing address
121 W VIRGINIA AVE, PINEVILLE, KY 40977-1600
(606) 337-3034
(606) 337-5305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4873
KY
1223G0001X
General Practice Dentistry
Primary
4873
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45001468
—
KY
05
—
60048733
—
KY
Enumeration date
12/08/2006
Last updated
08/14/2007
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