Jackie L Banahan D.M.D.

NPI 1093866154 - Dentist - 1223P0221X

NPI Details
NPI 1093866154
Gender Female
Enumeration Date 01/16/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3141 BEAUMONT CENTRE CIR
SUITE 100
LEXINGTON KY, 40513-1934, US
Phone (859) 223-4888
Fax (859) 296-4688
Business Location
3141 BEAUMONT CENTRE CIR
SUITE 100
LEXINGTON KY, 40513-1934, US
Phone (859) 223-4888
Fax (859) 296-4688
Toxanomy
Taxonomy Code 1223P0221X
License State Kentucky
License Number 4977
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According to our database, Dr. Jackie L Banahan D.M.D. NPI is 1093866154, taxonomy code is 1223P0221X and license number is 4977, license state is located at Kentucky. Jackie L Banahan D.M.D. physically located at 3141 Beaumont Centre Cir, Lexington KY, 40513-1934. NPI Number Jackie L Banahan D.M.D. has the Individual type.

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1093866154 NPI number is provided on an as is basis without warranty of any kind. 1093866154 is maintained by the National Plan & Provider Enumeration System. The contents of Jackie L Banahan D.M.D. are for informational purposes only.