Provider Demographics
NPI:1164642328
Name:ARNETTS DENTAL CLINIC
Entity Type:Organization
Organization Name:ARNETTS DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:606-784-7033
Mailing Address - Street 1:204 MOREHEAD PLAZA
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351
Mailing Address - Country:US
Mailing Address - Phone:606-784-7033
Mailing Address - Fax:606-784-7033
Practice Address - Street 1:204 MOREHEAD PLAZA
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-784-7033
Practice Address - Fax:606-784-7033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5482122300000X
KY6363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY61942165Medicaid