Provider Demographics
NPI:1457406175
Name:ERNEST O. SKAGGS DMD,PSC
Entity Type:Organization
Organization Name:ERNEST O. SKAGGS DMD,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:O
Authorized Official - Last Name:SKAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-351-3265
Mailing Address - Street 1:555 W LINCOLN TRAIL BLVD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-3301
Mailing Address - Country:US
Mailing Address - Phone:270-351-3265
Mailing Address - Fax:270-351-3557
Practice Address - Street 1:555 W LINCOLN TRAIL BLVD
Practice Address - Street 2:SUITE 25
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-3301
Practice Address - Country:US
Practice Address - Phone:270-351-3265
Practice Address - Fax:270-351-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty