Modern Kids Dentistry Of Elizabethtown, Pllc

LBN: Modern Kids Dentistry Of Elizabethtown, Pllc
Modern Kids Dentistry Of Elizabethtown, Pllc is an health care organization with primary practice located at 151 Drexler Cir # A , Elizabethtown KY 42701-7843. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Modern Kids Dentistry Of Elizabethtown, Pllc can be contacted via phone (859) 608-1579, or through Raybould, Justin Michael via phone (859) 321-7051.

Contact Information

Primary practice address
151 Drexler Cir # A Elizabethtown KY 42701-7843
Phone: (859) 608-1579
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Raybould, Justin Michael Doctor of Dental Medicine (DMD)
Phone: (859) 321-7051

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1285299149
LBN Legal business name Modern Kids Dentistry Of Elizabethtown, Pllc
DBA Doing business as
Authorized official Raybould, Justin Michael Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date May 7th, 2019
Last updated May 7th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285299149 NPPES
Kentucky MEDICAID 7100342680

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