# DENTAL SERVICES OF KENTUCKY, PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL SERVICES OF KENTUCKY, PSC
- **Other names:** ImmediaDent
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255585758
- **Legal business name:** DENTAL SERVICES OF KENTUCKY, PSC
- **Authorized official:** AMY WHEELER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (913) 800-6952

## Contact information

- **Practice address:** 4960 HOUSTON RD, STE G, FLORENCE, KY 41042-5132
- **Practice address phone:** (859) 371-1505
- **Practice address fax:** (866) 591-0604
- **Mailing address:** PO BOX 11568, OVERLAND PARK, KS 66207-4268
- **Mailing address phone:** (913) 428-1674
- **Mailing address fax:** (866) 591-0604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8972 | KY | Yes |

## Other

- **Enumeration date:** 11/11/2008
- **Last updated:** 04/12/2017