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Pediatric Dentistry Of Southern Kentucky
Pediatric Dentist in Bowling Green, Kentucky
NPI 1083067482

Pediatric Dentistry Of Southern Kentucky is a Pediatric Dentist based in Bowling Green, KY and is specialized in Pediatric Dentistry. Pediatric Dentistry Of Southern Kentucky practices in Bowling Green, KY. The NPI Number for Pediatric Dentistry Of Southern Kentucky is 1083067482 and holds a License No. 9156 (Kentucky).

The current practice location address for Pediatric Dentistry Of Southern Kentucky is 234 Natchez Trace Ave, Bowling Green, KY and can be reached out via phone at 270-715-5437 and via fax at 270-715-0032.

Location: 234 Natchez Trace Ave, Bowling Green, KY, 42103-7995
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083067482
Provider Name
Pediatric Dentistry Of Southern Kentucky
Credential
Provider Entity Type
Organization
Address
234 Natchez Trace Ave, Bowling Green, KY, 42103-7995
Phone Number
270-715-5437
Fax Number
270-715-0032
Provider Enumeration Date
07/20/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7100429210 05 KY
7100232870 05 KY
institution
Provider Business Practice Location Address Details
Address
234 Natchez Trace Ave
City
Bowling Green
State
Kentucky
Zip
42103-7995
Phone Number
270-715-5437
Fax Number
270-715-0032
person
Provider Business Mailing Address Details
Address
234 Natchez Trace Ave
City
Bowling Green
State
Kentucky
Zip
42103-7995
Phone Number
270-715-5437
Fax Number
270-715-0032
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
9156 (Kentucky)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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