| Lisette Baechtold, D.m.d., M.s. | |
|
2006 Merchant Dr Richmond KY 40475-8167 | |
| (859) 626-7977 | |
| (859) 626-5103 |
| Full Name | Lisette Baechtold, D.m.d., M.s. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2006 Merchant Dr, Richmond, Kentucky |
| Authorized Official Name and Position | Leslie Lisette Baechtold (DENTIST) |
| Authorized Official Contact | 8596267977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisette Baechtold, D.m.d., M.s. 2006 Merchant Dr Richmond KY 40475-8167 Ph: (859) 626-7977 | Lisette Baechtold, D.m.d., M.s. 2006 Merchant Dr Richmond KY 40475-8167 Ph: (859) 626-7977 |
| NPI Number | 1063508398 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 07/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063508398 | NPI | - | NPPES |
| 60066354 | Medicaid | KY | |
| 1603579 | Other | KY | UNITED CONCORDIA |
| 45004306 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6635 (Kentucky) | Secondary |
| 1223G0001X | Dentist - General Practice | 6635 (Kentucky) | Primary |
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