| Jeremy L Fairbourn Dds, Pllc | |
|
207 Alpine Dr Shelbyville KY 40065-8881 | |
| (502) 633-3900 | |
| Not Available |
| Full Name | Jeremy L Fairbourn Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 207 Alpine Dr, Shelbyville, Kentucky |
| Authorized Official Name and Position | Jeremy Lynn Fairbourn (MEMBER) |
| Authorized Official Contact | 5026333900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy L Fairbourn Dds, Pllc 207 Alpine Dr Shelbyville KY 40065-8881 Ph: () - | Jeremy L Fairbourn Dds, Pllc 207 Alpine Dr Shelbyville KY 40065-8881 Ph: (502) 633-3900 |
| NPI Number | 1396081576 |
|---|---|
| Provider Enumeration Date | 12/17/2012 |
| Last Update Date | 12/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396081576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9270 (Kentucky) | Primary |
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