Organization
CROFTON DENTAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTY EDWARD GAMBLE D.D.S. (DENTIST)
(270) 424-5999
Entity
Organization
Contact information
Practice address
115 E MILL ST, CROFTON, KY 42217-8021
(270) 424-5999
(270) 424-5522
Mailing address
115 E MILL ST, CROFTON, KY 42217-8021
(270) 424-5999
(270) 424-5522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7523
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60000304
—
KY
Enumeration date
10/28/2010
Last updated
10/28/2010
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