| A Choice Dental Care Pllc | |
|
111 Fairfax Ave Louisville KY 40207-4905 | |
| (502) 895-1171 | |
| (502) 899-7197 |
| Full Name | A Choice Dental Care Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 111 Fairfax Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Robert Earl Cooper (CEO) |
| Authorized Official Contact | 5028951171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Choice Dental Care Pllc 111 Fairfax Ave Louisville KY 40207-4905 Ph: (502) 895-1171 | A Choice Dental Care Pllc 111 Fairfax Ave Louisville KY 40207-4905 Ph: (502) 895-1171 |
| NPI Number | 1992929954 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992929954 | NPI | - | NPPES |
| 015370 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5765 (Kentucky) | Primary |
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