Wallace, Kenneth F

Wallace, Kenneth F is an individual health care provider with primary practice located at 280 Mt Zion Rd Suite D, Florence KY 41042. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wallace, Kenneth F can be contacted via phone (859) 283-1986.

Contact Information

Primary practice address
280 Mt Zion Rd Suite D Florence KY 41042
Fax: (859) 283-2586
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 6386 Kentucky

Profile Details

NPI number 1942342548
LBN Legal business name Wallace, Kenneth F
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2007
Last updated Nov 4th, 2015 - about 11 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 1942342548 NPPES
Kentucky MEDICAID 61942850

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