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Organization

PDOH DRE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES WHITE (MANAGER)
(859) 533-1109
Entity
Organization

Contact information

Practice address
2517 SIR BARTON WAY STE 200, LEXINGTON, KY 40509-2744
(859) 543-2456
Mailing address
105 SPRUCE ST, LEXINGTON, KY 40507-2109

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
10/19/2023
Last updated
10/19/2023
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