| Pediatric Dental Group Of Louisville | |
|
9710 Park Plaza Ave Suite 101 Louisville KY 40241-2291 | |
| (502) 327-6380 | |
| (502) 327-8650 |
| Full Name | Pediatric Dental Group Of Louisville |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9710 Park Plaza Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Connie Ison (BUSINESS MANAGER) |
| Authorized Official Contact | 5023276380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Group Of Louisville 9710 Park Plaza Ave Suite 101 Louisville KY 40241-2291 Ph: (502) 327-6380 | Pediatric Dental Group Of Louisville 9710 Park Plaza Ave Suite 101 Louisville KY 40241-2291 Ph: (502) 327-6380 |
| NPI Number | 1942329495 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942329495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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