| University Of Louisville School Of Dentistry | |
|
501 S Preston St Louisville KY 40202-1701 | |
| (502) 852-5096 | |
| (502) 852-1110 |
| Full Name | University Of Louisville School Of Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 501 S Preston St, Louisville, Kentucky |
| Authorized Official Name and Position | Timothy C Daugherty (ASSOC DEAN FOR CLINICAL AFFAIRS) |
| Authorized Official Contact | 5028520982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Louisville School Of Dentistry 501 S Preston St Louisville KY 40202-1701 Ph: (502) 852-5128 | University Of Louisville School Of Dentistry 501 S Preston St Louisville KY 40202-1701 Ph: (502) 852-5096 |
| NPI Number | 1861413098 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 07/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861413098 | NPI | - | NPPES |
| 1151798 | Other | KY | PASSPORT HEALTH PLAN SUHD |
| 61940102 | Medicaid | KY | |
| 100001450A | Medicaid | IN | |
| 1049975 | Other | KY | PASSPORT HEALTH PLAN FPP |
| 1048739 | Other | KY | PASSPORT HEALTH PLAN |
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