| Pediatric Dentistry Of Shelbyville | |
|
141 Stonecrest Rd Shelbyville KY 40065-8164 | |
| (502) 633-4441 | |
| (502) 633-4470 |
| Full Name | Pediatric Dentistry Of Shelbyville |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 141 Stonecrest Rd, Shelbyville, Kentucky |
| Authorized Official Name and Position | Amy E Raisor (OFFICE MANAGER) |
| Authorized Official Contact | 5026334441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Shelbyville 141 Stonecrest Rd Shelbyville KY 40065-8164 Ph: (502) 633-4441 | Pediatric Dentistry Of Shelbyville 141 Stonecrest Rd Shelbyville KY 40065-8164 Ph: (502) 633-4441 |
| NPI Number | 1770748790 |
|---|---|
| Provider Enumeration Date | 07/21/2008 |
| Last Update Date | 10/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770748790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7277 (Kentucky) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 7601 (Kentucky) | Primary |
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