| Kids Dentistry-jefferson Mall,pllc | |
|
5100 Outer Loop Suite C Louisville KY 40219-4056 | |
| (502) 969-9266 | |
| (502) 254-6054 |
| Full Name | Kids Dentistry-jefferson Mall,pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5100 Outer Loop, Louisville, Kentucky |
| Authorized Official Name and Position | Steve James (COO) |
| Authorized Official Contact | 5022548504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Dentistry-jefferson Mall,pllc Po Box 437169 Louisville KY 40253-7169 Ph: () - | Kids Dentistry-jefferson Mall,pllc 5100 Outer Loop Suite C Louisville KY 40219-4056 Ph: (502) 969-9266 |
| NPI Number | 1639357502 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 01/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639357502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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