Provider Demographics
NPI:1912037383
Name:DAY, ORDIE L II (DMD)
Entity Type:Individual
Prefix:DR
First Name:ORDIE
Middle Name:L
Last Name:DAY
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:914 N DIXIE AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2520
Mailing Address - Country:US
Mailing Address - Phone:270-737-6969
Mailing Address - Fax:270-769-6401
Practice Address - Street 1:914 N DIXIE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2520
Practice Address - Country:US
Practice Address - Phone:270-737-6969
Practice Address - Fax:270-769-6401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY47381223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYT83093Medicare UPIN