| Vineland Dental Centre | |
|
100 Vineland Centre Dr Suite 17 Vine Grove KY 40175-8430 | |
| (270) 877-2902 | |
| (270) 877-2903 |
| Full Name | Vineland Dental Centre |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Vineland Centre Dr, Vine Grove, Kentucky |
| Authorized Official Name and Position | John Mason (OWNER) |
| Authorized Official Contact | 5026365492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vineland Dental Centre 100 Vineland Centre Dr Suite 17 Vine Grove KY 40175-8430 Ph: () - | Vineland Dental Centre 100 Vineland Centre Dr Suite 17 Vine Grove KY 40175-8430 Ph: (270) 877-2902 |
| NPI Number | 1588105696 |
|---|---|
| Provider Enumeration Date | 03/09/2017 |
| Last Update Date | 03/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588105696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6309 (Kentucky) | Primary |
Main Street Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 W Main St, Vine Grove, KY 40175 Phone: 270-877-2011 |