Provider Demographics
NPI:1255903175
Name:BECHTEL, FRIEND (DMD)
Entity type:Individual
Prefix:
First Name:FRIEND
Middle Name:
Last Name:BECHTEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 MARY JO BLVD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-1960
Mailing Address - Country:US
Mailing Address - Phone:502-715-1322
Mailing Address - Fax:
Practice Address - Street 1:228 N UPPER ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1017
Practice Address - Country:US
Practice Address - Phone:502-715-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY106071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice