| Kentucky05 | |
|
3438 Taylor Blvd Louisville KY 40215-2648 | |
| (502) 366-4442 | |
| (502) 366-4446 |
| Full Name | Kentucky05 |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3438 Taylor Blvd, Louisville, Kentucky |
| Authorized Official Name and Position | Mandy Holland (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2565043326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky05 Po Box 2369 Anniston AL 36202-2369 Ph: (256) 241-3965 | Kentucky05 3438 Taylor Blvd Louisville KY 40215-2648 Ph: (502) 366-4442 |
| NPI Number | 1194103127 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 05/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194103127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Bardstown Road Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5300 Bardstown Rd, Louisville, KY 40291 Phone: 502-493-0302 | |
Mortenson Family Dental Center - Dixie At Rockford Lane, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4740 Dixie Hwy, Louisville, KY 40216 Phone: 502-447-8992 | |
Bbb - Fern Creek Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9360 Cedar Center Way, Louisville, KY 40291 Phone: 502-239-9070 Fax: 502-239-9078 | |
Tds Ky Five Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 Thierman Ln, Louisville, KY 40207 Phone: 502-896-2822 | |
Dental Health Professionals Of Kentucky, P.s.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7704 Bardstown Rd, Louisville, KY 40291 Phone: 502-200-5220 | |
Advanced Dental Center, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8517 Preston Hwy, Louisville, KY 40219 Phone: 502-966-4367 Fax: 502-966-4001 | |
Drs. Graham And Fortune, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9001 Galene Dr, Louisville, KY 40299 Phone: 502-267-8176 Fax: 502-267-8177 |