Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 9883 | KY |
NPI | 1003267162 |
---|---|
Provider Name | Dr. Garrett Sendor |
First Address | Danville, KY 40422-2537 |
Second Address | Danville, KY 40422-2537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 15/10/2021 |