# LIFETIME DENTAL CARE OF KY PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFETIME DENTAL CARE OF KY PSC
- **Other names:** Crescent Hill Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215169875
- **Legal business name:** LIFETIME DENTAL CARE OF KY PSC
- **Authorized official:** KIM ZUBER (INSURANCE / CREDENTIALING)
- **Authorized official phone:** (217) 540-5100

## Contact information

- **Practice address:** 2416 FRANKFORT AVE STE 3, LOUISVILLE, KY 40206-2571
- **Practice address phone:** (502) 893-1990
- **Practice address fax:** (502) 893-3690
- **Mailing address:** 2416 FRANKFORT AVE STE 3, LOUISVILLE, KY 40206-2571
- **Mailing address phone:** (502) 893-1990
- **Mailing address fax:** (502) 893-3690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7604 | KY | Yes |

## Other

- **Enumeration date:** 08/17/2009
- **Last updated:** 01/16/2017