| Pediatric Dentistry Of Hamburg | |
|
2517 Sir Barton Way Suite #200 Lexington KY 40509-2275 | |
| (859) 543-2456 | |
| (859) 543-2373 |
| Full Name | Pediatric Dentistry Of Hamburg |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2517 Sir Barton Way, Lexington, Kentucky |
| Authorized Official Name and Position | Rodney Allen Jackson (PEDODONTIST) |
| Authorized Official Contact | 8595432456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Hamburg 2517 Sir Barton Way Suite #200 Lexington KY 40509-2275 Ph: (859) 543-2456 | Pediatric Dentistry Of Hamburg 2517 Sir Barton Way Suite #200 Lexington KY 40509-2275 Ph: (859) 543-2456 |
| NPI Number | 1790992220 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790992220 | NPI | - | NPPES |
| 60004041 | Medicaid | KY | |
| 60002201 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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