Provider Demographics
NPI:1942474069
Name:ESCHELBACH, KAY M (DMD)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:M
Last Name:ESCHELBACH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KAY
Other - Last Name:ESCHELBACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:621 EDGEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356
Mailing Address - Country:US
Mailing Address - Phone:859-885-4621
Mailing Address - Fax:859-887-0375
Practice Address - Street 1:621 EDGEWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356
Practice Address - Country:US
Practice Address - Phone:859-885-4621
Practice Address - Fax:859-887-0375
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY57741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice