| 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 |
|---|---|
| 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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