| Kenneth F. Wallace | |
|
280 Mount Zion Rd Suite D Florence KY 41042-3217 | |
| (859) 283-1986 | |
| (859) 283-2586 |
| Full Name | Kenneth F. Wallace |
|---|---|
| Speciality | Dentist |
| Location | 280 Mount Zion Rd, Florence, Kentucky |
| Authorized Official Name and Position | Kenneth Franklin Wallace (DENTIST) |
| Authorized Official Contact | 8592831986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth F. Wallace 280 Mount Zion Rd Suite D Florence KY 41042-3217 Ph: (859) 283-1986 | Kenneth F. Wallace 280 Mount Zion Rd Suite D Florence KY 41042-3217 Ph: (859) 283-1986 |
| NPI Number | 1952561375 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952561375 | NPI | - | NPPES |
| 60063864 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6386 (Kentucky) | Primary |
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