Provider Demographics
NPI:1134261589
Name:DENTAL DESIGNS OF OWENSBORO
Entity type:Organization
Organization Name:DENTAL DESIGNS OF OWENSBORO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WES
Authorized Official - Last Name:BOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-684-3377
Mailing Address - Street 1:3310 PROFESSIONAL PARK
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303
Mailing Address - Country:US
Mailing Address - Phone:270-684-3377
Mailing Address - Fax:270-684-3348
Practice Address - Street 1:3310 PROFESSIONAL PARK DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303
Practice Address - Country:US
Practice Address - Phone:270-684-3377
Practice Address - Fax:270-684-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY79411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty