Provider Demographics
NPI:1033249420
Name:ASSOCIATES FOR DENTAL ARTS, PLLC
Entity Type:Organization
Organization Name:ASSOCIATES FOR DENTAL ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOTTOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-886-3644
Mailing Address - Street 1:311 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-2129
Mailing Address - Country:US
Mailing Address - Phone:270-886-3644
Mailing Address - Fax:270-886-2577
Practice Address - Street 1:311 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2129
Practice Address - Country:US
Practice Address - Phone:270-886-3644
Practice Address - Fax:270-886-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty