Provider Demographics
NPI:1700829124
Name:CECIL, III, JAMES C (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:CECIL, III
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2109 LEAFLAND PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1142
Mailing Address - Country:US
Mailing Address - Phone:502-564-3246
Mailing Address - Fax:502-564-8389
Practice Address - Street 1:275 EAST MAIN ST
Practice Address - Street 2:HS2W-B
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40621-0001
Practice Address - Country:US
Practice Address - Phone:502-564-3246
Practice Address - Fax:502-564-8389
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39121223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health