Provider Demographics
NPI:1659594042
Name:BUTTERMILK FAMILY AND COSMETIC DENTISTRY
Entity type:Organization
Organization Name:BUTTERMILK FAMILY AND COSMETIC DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DICKHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-344-9222
Mailing Address - Street 1:2325 BUTTERMILK XING
Mailing Address - Street 2:
Mailing Address - City:CRESCENT SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1622
Mailing Address - Country:US
Mailing Address - Phone:859-344-9222
Mailing Address - Fax:859-344-1490
Practice Address - Street 1:2325 BUTTERMILK XING
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1622
Practice Address - Country:US
Practice Address - Phone:859-344-9222
Practice Address - Fax:859-344-1490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty