Carlisle Family Dental | |
110 S Locust St Carlisle KY 40311-1123 | |
(859) 289-5418 | |
(859) 289-8153 |
Full Name | Carlisle Family Dental |
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Speciality | Clinic/center - Dental |
Location | 110 S Locust St, Carlisle, Kentucky |
Authorized Official Name and Position | Brandon Ira Allen (OWNER/DENTIST) |
Authorized Official Contact | 8592277290 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Carlisle Family Dental 110 S Locust St Carlisle KY 40311-1123 Ph: (859) 289-5418 | Carlisle Family Dental 110 S Locust St Carlisle KY 40311-1123 Ph: (859) 289-5418 |
NPI Number | 1245505908 |
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Provider Enumeration Date | 03/14/2012 |
Last Update Date | 03/14/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245505908 | NPI | - | NPPES |
7100053320 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 8056 (Kentucky) | Primary |
Carlisle Family Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 S Locust St, Carlisle, KY 40311 Phone: 859-289-5418 | |
Mortenson Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 N. Locust St, Carlisle, KY 40311 Phone: 859-289-5418 Fax: 859-289-8153 |