Provider Demographics
NPI:1720481609
Name:PLEASANT, DAMON (DMD)
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:
Last Name:PLEASANT
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 1:3138 CUSTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4064
Mailing Address - Country:US
Mailing Address - Phone:859-273-4141
Mailing Address - Fax:859-273-4866
Practice Address - Street 1:3138 CUSTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4064
Practice Address - Country:US
Practice Address - Phone:859-273-4141
Practice Address - Fax:859-273-4866
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3780122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist