Individual
DR. ELISHADIE TEZERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2333 ALEXANDRIA DR, LEXINGTON, KY 40504-3215
(877) 277-9892
Mailing address
PO BOX 1278, BARDSTOWN, KY 40004-4278
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10543
KY
1223G0001X
General Practice Dentistry
Primary
10543
KY
Other
Enumeration date
01/29/2021
Last updated
09/09/2021
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