| Louisville Dental Sleep Medicine Pllc | |
|
3935 Dupont Cir Suite C Louisville KY 40207-4824 | |
| (502) 458-7476 | |
| (502) 458-7797 |
| Full Name | Louisville Dental Sleep Medicine Pllc |
|---|---|
| Speciality | Dentist |
| Location | 3935 Dupont Cir, Louisville, Kentucky |
| Authorized Official Name and Position | John Merton Mccrillis (OWNER) |
| Authorized Official Contact | 5024587476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Dental Sleep Medicine Pllc 3935 Dupont Cir Suite C Louisville KY 40207-4824 Ph: (502) 458-7476 | Louisville Dental Sleep Medicine Pllc 3935 Dupont Cir Suite C Louisville KY 40207-4824 Ph: (502) 458-7476 |
| NPI Number | 1912354200 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 05/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912354200 | NPI | - | NPPES |
| 610937390 | Other | KY | TRICARE |
| 610937390 | Other | KY | HUMANA |
| 610937390 | Other | KY | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | KY4612 (Kentucky) | Primary |
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