# KIDS DENTISTRY-JEFFERSONVILLE, LLC

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

## Provider details

- **NPI number:** 1184904328
- **Authorized official:** STEVE JAMES (CFO)
- **Authorized official phone:** (502) 254-8504

## Contact information

- **Practice address:** 2917 E 10TH ST, 105, JEFFERSONVILLE, IN 47130-6916
- **Practice address phone:** (812) 284-2103
- **Mailing address:** PO BOX 437169, LOUISVILLE, KY 40253-7169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2011
- **Last updated:** 08/19/2011