Provider Demographics
NPI:1245455120
Name:C K DENTAL, INC.
Entity type:Organization
Organization Name:C K DENTAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:MEUNIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-955-1606
Mailing Address - Street 1:3564 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8984
Mailing Address - Country:US
Mailing Address - Phone:502-955-1606
Mailing Address - Fax:
Practice Address - Street 1:3564 WILLOW WAY
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-8984
Practice Address - Country:US
Practice Address - Phone:502-955-1606
Practice Address - Fax:502-955-1439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY66921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty