Organization
DENTRUST KENTUCKY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CLARK (DIRECTOR OF CREDENTIALING)
(813) 451-4503
Entity
Organization
Contact information
Practice address
2840 BASTOGNE AVE, FORT CAMPBELL, KY 42223-5114
(267) 927-5000
Mailing address
6097 EASTON RD, PIPERSVILLE, PA 18947-1810
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
02/08/2023
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