| Paducah Pediatric Dentistry Psc | |
|
2850 Lone Oak Rd Suite 1 Paducah KY 42003-8043 | |
| (270) 554-3131 | |
| (270) 554-0124 |
| Full Name | Paducah Pediatric Dentistry Psc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2850 Lone Oak Rd, Paducah, Kentucky |
| Authorized Official Name and Position | James Dennis Johnston (PRESIDENT) |
| Authorized Official Contact | 2705543131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paducah Pediatric Dentistry Psc 2850 Lone Oak Rd Suite 1 Paducah KY 42003-8043 Ph: (270) 554-3131 | Paducah Pediatric Dentistry Psc 2850 Lone Oak Rd Suite 1 Paducah KY 42003-8043 Ph: (270) 554-3131 |
| NPI Number | 1295740926 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295740926 | NPI | - | NPPES |
| 60042181 | Medicaid | KY | |
| 45002524 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4218 (Kentucky) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 4218 (Kentucky) | Primary |
Bohle Family Dentistry, Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1836 Broadway St, Paducah, KY 42001 Phone: 270-442-0256 Fax: 270-442-8730 | |
Tritle Family Dentistry, Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2418 New Holt Rd, Paducah, KY 42001 Phone: 270-554-4445 Fax: 270-554-4248 | |
Purchase Endodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3429 Lone Oak Rd Ste 1, Paducah, KY 42003 Phone: 270-534-8881 Fax: 270-534-0115 | |
Bret A. Avra, Dmd, Psc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2605 Kentucky Ave, Ste #302, Paducah, KY 42003 Phone: 270-443-1717 Fax: 270-443-0517 | |
Broadway Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2018 Broadway, Paducah, KY 42001 Phone: 270-443-9099 Fax: 270-443-9052 | |
Dr Daniel Boeh Dmd Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Fountain Ave, Suite #314, Paducah, KY 42001 Phone: 270-444-6032 Fax: 270-444-7843 | |
Broadway Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2018 Broadway St, Paducah, KY 42001 Phone: 270-443-9099 Fax: 270-443-9052 |