# ADVANCED DENTAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023180536
- **Authorized official:** DR. RACHEL TALIS D.M.D. (OWNER)
- **Authorized official phone:** (502) 966-4367

## Contact information

- **Practice address:** 8517 PRESTON HWY, LOUISVILLE, KY 40219-5301
- **Practice address phone:** (502) 966-4367
- **Practice address fax:** (502) 966-4001
- **Mailing address:** 8517 PRESTON HWY, LOUISVILLE, KY 40219-5301
- **Mailing address phone:** (502) 966-4367
- **Mailing address fax:** (502) 966-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 09/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1477904498 | NPI | KY |
| 05 | — | 60071180 | — | KY |
| 05 | — | 7100317780 | — | KY |