Organization
FAMILY DENTAL CARE ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY BRENT FULTZ DMD (SEC TREAS)
(859) 371-3950
Entity
Organization
Contact information
Practice address
6616 DIXIE HWY, #1, FLORENCE, KY 41042
(859) 371-3950
Mailing address
6616 DIXIE HWY, #1, FLORENCE, KY 41042
(859) 371-3950
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61941936
—
KY
Enumeration date
01/16/2007
Last updated
10/02/2007
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