Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | KY |
NPI | 1124510581 |
---|---|
Provider Name | Dr. Kristen Elena Eguren |
First Address | Louisville, KY 40203-2177 |
Second Address | Louisville, KY 40202-1701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2018 |
Last Update Date | 01/06/2018 |