Provider Demographics
NPI:1396020301
Name:DENTAL HEALTH ASSOCIATES PSC
Entity Type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JEWELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEADE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-987-3290
Mailing Address - Street 1:2115 ROCKY DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1370
Mailing Address - Country:US
Mailing Address - Phone:859-987-3290
Mailing Address - Fax:859-987-6800
Practice Address - Street 1:2115 ROCKY DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-1370
Practice Address - Country:US
Practice Address - Phone:859-987-3290
Practice Address - Fax:859-987-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty