Provider Demographics
NPI:1316152606
Name:KINGDOM FAMILY DENTISTRY
Entity type:Organization
Organization Name:KINGDOM FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SWOPE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-742-2322
Mailing Address - Street 1:772 WAYCROSS RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3141
Mailing Address - Country:US
Mailing Address - Phone:513-742-2322
Mailing Address - Fax:513-742-5619
Practice Address - Street 1:772 WAYCROSS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3141
Practice Address - Country:US
Practice Address - Phone:513-742-2322
Practice Address - Fax:513-742-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH19004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty