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303 S 4th St Ste 201 Danville KY 40422-2091 | |
| (859) 236-8448 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 303 S 4th St Ste 201, Danville, Kentucky |
| Authorized Official Name and Position | Jeffrey Todd Johnson (MANAGER) |
| Authorized Official Contact | 8593274711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2505 Larkin Rd Ste 201 Lexington KY 40503-3256 Ph: (859) 396-3347 | 303 S 4th St Ste 201 Danville KY 40422-2091 Ph: (859) 236-8448 |
| NPI Number | 1831606094 |
|---|---|
| Provider Enumeration Date | 01/09/2018 |
| Last Update Date | 01/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831606094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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