| Isgrigg Famiily Dentistry, Llc | |
|
101 Manor Ave Suite 103 Bardstown KY 40004-2298 | |
| (502) 348-3119 | |
| Not Available |
| Full Name | Isgrigg Famiily Dentistry, Llc |
|---|---|
| Speciality | Dentist |
| Location | 101 Manor Ave, Bardstown, Kentucky |
| Authorized Official Name and Position | Nita S Isgrigg (OWNER) |
| Authorized Official Contact | 5023483119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Isgrigg Famiily Dentistry, Llc 101 Manor Ave Suite 103 Bardstown KY 40004-2298 Ph: (502) 348-3119 | Isgrigg Famiily Dentistry, Llc 101 Manor Ave Suite 103 Bardstown KY 40004-2298 Ph: (502) 348-3119 |
| NPI Number | 1619161825 |
|---|---|
| Provider Enumeration Date | 08/30/2007 |
| Last Update Date | 08/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619161825 | NPI | - | NPPES |
| 60073590 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7359 (Kentucky) | Primary |
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