Provider Demographics
NPI:1619475456
Name:PAUL E. ARNOLD, DMD., PSC.
Entity Type:Organization
Organization Name:PAUL E. ARNOLD, DMD., PSC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:606-836-6022
Mailing Address - Street 1:850 DIEDERICH BLVD
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KY
Mailing Address - Zip Code:41169-1807
Mailing Address - Country:US
Mailing Address - Phone:606-836-6022
Mailing Address - Fax:606-836-0582
Practice Address - Street 1:850 DIEDERICH BLVD
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KY
Practice Address - Zip Code:41169-1807
Practice Address - Country:US
Practice Address - Phone:606-836-6022
Practice Address - Fax:606-836-0582
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAUL E. ARNOLD, DMD., PSC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6799332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies