Provider Demographics
NPI:1508060070
Name:PENNYRILE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:PENNYRILE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-885-4822
Mailing Address - Street 1:623 MILLBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-5241
Mailing Address - Country:US
Mailing Address - Phone:270-885-4822
Mailing Address - Fax:270-885-0812
Practice Address - Street 1:623 MILLBROOKE DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-5241
Practice Address - Country:US
Practice Address - Phone:270-885-4822
Practice Address - Fax:270-885-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty