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Organization
OLD LOUISVILLE DENTAL CENTRE
Active
Organization
OLD LOUISVILLE DENTAL CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ELIZABETH FAETH (OFFICE MANAGER)
(502) 718-1226
Entity
Organization
Contact information
Practice address
1504 S 7TH ST, LOUISVILLE, KY 40208-1711
(502) 636-5492
(502) 636-9210
Mailing address
1504 S 7TH ST, LOUISVILLE, KY 40208-1711
(502) 636-5492
(502) 636-9210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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