Organization
DENTAL SERVICES OF KENTUCKY, PSC
Active
Parent organization
DENTAL SERVICES OF KENTUCKY, PSC
Other names
ImmediaDent
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL SERVICES OF KENTUCKY, PSC
Authorized official
AMY WHEELER (CREDENTIALING COORDINATOR)
(913) 800-6952
Entity
Organization
Contact information
Practice address
2358 NICHOLASVILLE RD, #156, LEXINGTON, KY 40503-3032
(859) 381-0680
(859) 381-0633
Mailing address
PO BOX 11568, STE 155, OVERLAND, KS 66207-4268
(913) 428-1674
(866) 591-0604
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100058850
—
KY
Enumeration date
09/23/2008
Last updated
04/12/2017
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