Provider First Line Business Practice Location Address:
740 S LIMESTONE STE E-214
Provider Second Line Business Practice Location Address:
UNIV OF KENTUCKY COLLEGE OF DENTISTRY/OROFACIAL PAIN
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-5500
Provider Business Practice Location Address Fax Number:
859-323-0001
Provider Enumeration Date:
08/26/2015