Falls City Family Dentistry | |
3050 W Broadway Louisville KY 40211-1475 | |
(502) 778-2631 | |
(502) 776-3454 |
Full Name | Falls City Family Dentistry |
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Speciality | Dentist - General Practice |
Location | 3050 W Broadway, Louisville, Kentucky |
Authorized Official Name and Position | Susie J. Riley (OWNER) |
Authorized Official Contact | 5027782631 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Falls City Family Dentistry 3050 W Broadway Louisville KY 40211-1475 Ph: (502) 778-2631 | Falls City Family Dentistry 3050 W Broadway Louisville KY 40211-1475 Ph: (502) 778-2631 |
NPI Number | 1649325457 |
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Provider Enumeration Date | 01/24/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649325457 | NPI | - | NPPES |
61942785 | Medicaid | KY | |
168938 | Other | KY | MEDICAID SUBCONTRACTOR # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 5214 (Kentucky) | Primary |
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