| William E Shores Jr Psc | |
|
3122 Custer Dr Ste B Lexington KY 40517-4000 | |
| (859) 273-2224 | |
| (859) 273-3725 |
| Full Name | William E Shores Jr Psc |
|---|---|
| Speciality | Dentist |
| Location | 3122 Custer Dr, Lexington, Kentucky |
| Authorized Official Name and Position | William E Shores (PRESIDENT) |
| Authorized Official Contact | 8592732224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| William E Shores Jr Psc 3122 Custer Dr Ste B Lexington KY 40517-4000 Ph: (859) 273-2224 | William E Shores Jr Psc 3122 Custer Dr Ste B Lexington KY 40517-4000 Ph: (859) 273-2224 |
| NPI Number | 1134493893 |
|---|---|
| Provider Enumeration Date | 02/28/2012 |
| Last Update Date | 02/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134493893 | NPI | - | NPPES |
| 60057072 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5707 (Kentucky) | Primary |
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