# RAKUTT AND PAYNE DENTAL PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Louisville Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023435823
- **Authorized official:** DR. SANDRA LEIGH PAYNE DMD (OWNER)
- **Authorized official phone:** (502) 582-2004

## Contact information

- **Practice address:** 801 BARRET AVE, LOUISVILLE, KY 40204-1747
- **Practice address phone:** (502) 582-2004
- **Practice address fax:** (502) 582-2032
- **Mailing address:** 801 BARRET AVE, \#107, LOUISVILLE, KY 40204-1747
- **Mailing address phone:** (502) 582-2004
- **Mailing address fax:** (502) 582-2032

## Taxonomy

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

## Other

- **Enumeration date:** 03/19/2014
- **Last updated:** 03/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 60064375 | — | KY |
| 05 | — | 60064516 | — | KY |