Faith Dental Of Berea | |
206 Richmond Rd N Berea KY 40403-1319 | |
(859) 986-8491 | |
Not Available |
Full Name | Faith Dental Of Berea |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 206 Richmond Rd N, Berea, Kentucky |
Authorized Official Name and Position | Logan Roy Antle (CEO) |
Authorized Official Contact | 6064255768 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Faith Dental Of Berea 521 Crane Rd Somerset KY 42501-9503 Ph: (606) 425-5768 | Faith Dental Of Berea 206 Richmond Rd N Berea KY 40403-1319 Ph: (859) 986-8491 |
NPI Number | 1326818238 |
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Provider Enumeration Date | 01/03/2024 |
Last Update Date | 01/03/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326818238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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