Provider First Line Business Practice Location Address:
800 ROSE ST RM D104
Provider Second Line Business Practice Location Address:
UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-257-1494
Provider Business Practice Location Address Fax Number:
859-257-5859
Provider Enumeration Date:
12/12/2006