Grace, Amanda Elizabeth

Grace, Amanda Elizabeth is an individual health care provider with primary practice located at 1080 Ben Ali Drive Suite A, Danville KY 40422-2547. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Grace, Amanda Elizabeth can be contacted via phone (859) 236-6900.

Contact Information

Primary practice address
1080 Ben Ali Drive Suite A Danville KY 40422-2547
Phone: (859) 236-6900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8778 Kentucky
Dental Providers / Pediatric Dentistry 1223P0221X 8778 Kentucky

Profile Details

NPI number 1134353576
LBN Legal business name Grace, Amanda Elizabeth
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2009
Last updated Feb 8th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134353576 NPPES
Kentucky MEDICAID 7100123440

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