# PADDOCK DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PADDOCK DENTAL
- **Other names:** Pearl Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033860341
- **Legal business name:** PADDOCK DENTAL
- **Authorized official:** ANGELA F LAIACONO (FRONT DESK)
- **Authorized official phone:** (502) 451-2212

## Contact information

- **Practice address:** 3002 BARDSTOWN RD, LOUISVILLE, KY 40205-3020
- **Practice address phone:** (502) 451-2212
- **Practice address fax:** (502) 456-0849
- **Mailing address:** 3002 BARDSTOWN RD, LOUISVILLE, KY 40205-3020
- **Mailing address phone:** (502) 451-2212
- **Mailing address fax:** (502) 456-0849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2022
- **Last updated:** 01/18/2022