| Portland Dental Psc | |
|
465 North 26th Street Louisville KY 40212 | |
| (502) 778-7678 | |
| Not Available |
| Full Name | Portland Dental Psc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 465 North 26th Street, Louisville, Kentucky |
| Authorized Official Name and Position | Rodney Brent Fultz (SEC TREAS) |
| Authorized Official Contact | 5027787678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Dental Psc 465 North 26th Street Louisville KY 40212 Ph: (502) 778-7678 | Portland Dental Psc 465 North 26th Street Louisville KY 40212 Ph: (502) 778-7678 |
| NPI Number | 1528118601 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 12/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528118601 | NPI | - | NPPES |
| 61942447 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (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 |