Individual
DR. JASON JOHNSON MCILVAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
111 KY HIGHWAY 32 W STE 2, CYNTHIANA, KY 41031-8574
(859) 234-9944
(859) 234-9942
Mailing address
835 MT VERNON RD, CYNTHIANA, KY 41031-5617
(859) 576-5910
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8719
KY
1223G0001X
General Practice Dentistry
8719
KY
Other
Enumeration date
05/27/2009
Last updated
06/08/2016
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