| Family Dental Of Whitley City | |
|
19 Medical Loop Suite 3 Whitley City KY 42653-4382 | |
| (606) 376-2976 | |
| (888) 960-2041 |
| Full Name | Family Dental Of Whitley City |
|---|---|
| Speciality | Clinic/Center |
| Location | 19 Medical Loop, Whitley City, Kentucky |
| Authorized Official Name and Position | Eric E Loy (CEO) |
| Authorized Official Contact | 2708586655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Of Whitley City Po Box 1080 360 Keen Street Burkesville KY 42717-1080 Ph: (270) 858-6655 | Family Dental Of Whitley City 19 Medical Loop Suite 3 Whitley City KY 42653-4382 Ph: (606) 376-2976 |
| NPI Number | 1164922480 |
|---|---|
| Provider Enumeration Date | 02/13/2018 |
| Last Update Date | 02/02/2023 |
| Medicare PECOS PAC ID | 6305947789 |
|---|---|
| Medicare Enrollment ID | O20150817000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164922480 | NPI | - | NPPES |
| 7100017280 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700172 (Kentucky) | Primary |
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