Provider Demographics
NPI:1447468186
Name:DENTISTRY FOR TODAY PSC
Entity type:Organization
Organization Name:DENTISTRY FOR TODAY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-226-6700
Mailing Address - Street 1:720 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-1337
Mailing Address - Country:US
Mailing Address - Phone:502-839-6828
Mailing Address - Fax:502-839-6820
Practice Address - Street 1:720 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-1337
Practice Address - Country:US
Practice Address - Phone:502-839-6828
Practice Address - Fax:502-839-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY69481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty