| Community Care Of Kentucky, Inc | |
|
122 S Lee Trover Todd Jr Hwy Earlington KY 42410-1557 | |
| (270) 383-5511 | |
| Not Available |
| Full Name | Community Care Of Kentucky, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 122 S Lee Trover Todd Jr Hwy, Earlington, Kentucky |
| Authorized Official Name and Position | Jenell Stump (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 2703835511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Of Kentucky, Inc Po Box 2369 Anniston AL 36202-2369 Ph: (256) 741-7340 | Community Care Of Kentucky, Inc 122 S Lee Trover Todd Jr Hwy Earlington KY 42410-1557 Ph: (270) 383-5511 |
| NPI Number | 1962880997 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 01/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962880997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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