| Barren River Dental Clinic | |
|
1109 State St Bowling Green KY 42101-2648 | |
| (270) 781-8039 | |
| (270) 796-8946 |
| Full Name | Barren River Dental Clinic |
|---|---|
| Speciality | Public Health Or Welfare |
| Location | 1109 State St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Dennis R Chaney (DISTRICT DIRECTOR) |
| Authorized Official Contact | 2707818039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Barren River Dental Clinic Po Box 1157 Bowling Green KY 42102-1157 Ph: (270) 781-8039 | Barren River Dental Clinic 1109 State St Bowling Green KY 42101-2648 Ph: (270) 781-8039 |
| NPI Number | 1700102852 |
|---|---|
| Provider Enumeration Date | 04/14/2010 |
| Last Update Date | 08/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700102852 | NPI | - | NPPES |
| 303114Z | Other | KY | CLINIC SITE |
| 7100120040 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Secondary |
| 251K00000X | Public Health Or Welfare | (* (Not Available)) | Primary |
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