Bellefonte Family Dental Care, Psc | |
1592 Diederich Blvd Russell KY 41169-1676 | |
(606) 836-9962 | |
(606) 836-4668 |
Full Name | Bellefonte Family Dental Care, Psc |
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Speciality | Dentist - General Practice |
Location | 1592 Diederich Blvd, Russell, Kentucky |
Authorized Official Name and Position | Lisa Renee Dean (OWNER) |
Authorized Official Contact | 6068369962 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bellefonte Family Dental Care, Psc 1592 Diederich Blvd Russell KY 41169-1676 Ph: (606) 836-9962 | Bellefonte Family Dental Care, Psc 1592 Diederich Blvd Russell KY 41169-1676 Ph: (606) 836-9962 |
NPI Number | 1285910406 |
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Provider Enumeration Date | 11/02/2011 |
Last Update Date | 11/02/2011 |
Identifier | Type | State | Issuer |
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1285910406 | NPI | - | NPPES |
60068905 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 6890 (Kentucky) | Primary |