Provider Demographics
NPI:1598865180
Name:CASH, CLARK D (DMD)
Entity Type:Individual
Prefix:DR
First Name:CLARK
Middle Name:D
Last Name:CASH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 COMANCHE TRL
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-1753
Mailing Address - Country:US
Mailing Address - Phone:502-227-1931
Mailing Address - Fax:866-365-5499
Practice Address - Street 1:635 COMANCHE TRL
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-1753
Practice Address - Country:US
Practice Address - Phone:502-227-1931
Practice Address - Fax:866-365-5499
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY60151223G0001X
KY5221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice