Provider Demographics
NPI:1982642864
Name:HARVEY, MARTHA LEIGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:LEIGH
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 LEXINGTON RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1798
Mailing Address - Country:US
Mailing Address - Phone:859-873-4451
Mailing Address - Fax:859-873-3243
Practice Address - Street 1:426 LEXINGTON RD
Practice Address - Street 2:SUITE 150
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1798
Practice Address - Country:US
Practice Address - Phone:859-873-4451
Practice Address - Fax:859-873-3243
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY66301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice