Pat Disponett Dmd | |
919 Chambers Blvd Suite A Bardstown KY 40004-2573 | |
(502) 348-6404 | |
(502) 348-6342 |
Full Name | Pat Disponett Dmd |
---|---|
Speciality | Dentist - General Practice |
Location | 919 Chambers Blvd, Bardstown, Kentucky |
Authorized Official Name and Position | Joshua Dolphus Blackmon (MEMBER / PARTNER) |
Authorized Official Contact | 5023486404 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pat Disponett Dmd 919 Chambers Blvd Bardstown KY 40004 Ph: (502) 348-6404 | Pat Disponett Dmd 919 Chambers Blvd Suite A Bardstown KY 40004-2573 Ph: (502) 348-6404 |
NPI Number | 1437297348 |
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Provider Enumeration Date | 02/02/2007 |
Last Update Date | 10/24/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437297348 | NPI | - | NPPES |
6238 | Other | KY | PASSPORT |
61943601 | Medicaid | KY | |
267366 | Other | KY | UNITED CONCORDIA PROVIDER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 6805 (Kentucky) | Primary |
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