Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 7122 | KY |
Y | 1223E0200X | Endodontist | 7122 | KY |
NPI | 1063586261 |
---|---|
Provider Name | Dr. Gregory Alan Carman |
First Address | Lexington, KY 40517-4125 |
Second Address | Lexington, KY 40517-4125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 11/09/2014 |