| Jeffersonville Pediatric Dentistry Llc | |
|
2929 Charlestown Pike Jeffersonville IN 47130-8199 | |
| (502) 994-0389 | |
| Not Available |
| Full Name | Jeffersonville Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2929 Charlestown Pike, Jeffersonville, Indiana |
| Authorized Official Name and Position | Porchusa Larai Combs (PEDIATRIC DENTIST) |
| Authorized Official Contact | 5029940389 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffersonville Pediatric Dentistry Llc 702 Park Creek Cir Louisville KY 40245-6241 Ph: (502) 994-0389 | Jeffersonville Pediatric Dentistry Llc 2929 Charlestown Pike Jeffersonville IN 47130-8199 Ph: (502) 994-0389 |
| NPI Number | 1548917982 |
|---|---|
| Provider Enumeration Date | 03/06/2022 |
| Last Update Date | 03/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548917982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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