Organization
LICKING VALLEY DENTAL ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES STEPHEN CLYDE DMD (PRESIDENT)
(859) 234-3323
Entity
Organization
Contact information
Practice address
114 S MAIN ST, CYNTHIANA, KY 41031-1521
(859) 234-3323
(859) 234-3332
Mailing address
114 S MAIN ST, CYNTHIANA, KY 41031-1521
(859) 234-3323
(859) 234-3332
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4932
KY
Other
Enumeration date
12/27/2006
Last updated
08/22/2020
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