| Smile Station Family Dentistry, Llc | |
|
5504 Reidland Rd Paducah KY 42003-0955 | |
| (270) 408-1234 | |
| Not Available |
| Full Name | Smile Station Family Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5504 Reidland Rd, Paducah, Kentucky |
| Authorized Official Name and Position | Donald Scott Bridges (MEMBER) |
| Authorized Official Contact | 2705197342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Station Family Dentistry, Llc 710 Windsor Woods Paducah KY 42001-4676 Ph: (270) 408-1234 | Smile Station Family Dentistry, Llc 5504 Reidland Rd Paducah KY 42003-0955 Ph: (270) 408-1234 |
| NPI Number | 1689024465 |
|---|---|
| Provider Enumeration Date | 06/13/2016 |
| Last Update Date | 06/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689024465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7956 (Kentucky) | Secondary |
| 261QD0000X | Clinic/center - Dental | 7956 (Kentucky) | Primary |
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