Booneville Family Dentistry

NPI 1053557660 - Dentist - 1223G0001X

NPI Details
NPI 1053557660
Enumeration Date 01/02/2009
Last Updated 01/02/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name JASON WYNN JASON
Position OWNER
Phone (606) 723-1000
Fax (606) 723-1039
Practice Location
706 NORTH COURTHOUSE SQUARE
BOONEVILLE KY, 41314, US
Phone (606) 723-1000
Fax (606) 723-1039
Business Location
PO BOX 1167
BOONEVILLE KY, 41314-1167, US
Phone (606) 723-1000
Fax (606) 723-1039
Toxanomy
Taxonomy Code 1223G0001X
License State Kentucky
License Number 7138
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According to our database, Booneville Family Dentistry NPI is 1053557660, taxonomy code is 1223G0001X and license number is 7138, license state is located at Kentucky. Booneville Family Dentistry physically located at 706 North Courthouse Square, Booneville KY, 41314. NPI Number 1033115704 has the healthcare provider type.

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1053557660 NPI number is provided on an as is basis without warranty of any kind. 1053557660 is maintained by the National Plan & Provider Enumeration System. The contents of Booneville Family Dentistry are for informational purposes only.