Isgrigg Famiily Dentistry, Llc | |
101 Manor Ave Suite 103 Bardstown KY 40004-2298 | |
(502) 348-3119 | |
Not Available |
Full Name | Isgrigg Famiily Dentistry, Llc |
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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 |
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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 |
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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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