| Thomas R. Vivian Dmd Pllc | |
|
10515 Meeting St 104 Prospect KY 40059-6523 | |
| (502) 420-2480 | |
| (502) 420-2891 |
| Full Name | Thomas R. Vivian Dmd Pllc |
|---|---|
| Speciality | Dentist |
| Location | 10515 Meeting St, Prospect, Kentucky |
| Authorized Official Name and Position | Thomas Vivian (DR/OWNER) |
| Authorized Official Contact | 5024202480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas R. Vivian Dmd Pllc 10515 Meeting St 104 Prospect KY 40059-6523 Ph: (502) 420-2480 | Thomas R. Vivian Dmd Pllc 10515 Meeting St 104 Prospect KY 40059-6523 Ph: (502) 420-2480 |
| NPI Number | 1649598921 |
|---|---|
| Provider Enumeration Date | 05/11/2010 |
| Last Update Date | 05/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649598921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8638 (Kentucky) | Primary |
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