# SMILE ACADEMY OF KENTUCKY

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

## Provider details

- **NPI number:** 1265805717
- **Authorized official:** MRS. CARRIE A SHUFFITT (MEMBER)
- **Authorized official phone:** (812) 786-8751

## Contact information

- **Practice address:** 2776 CAMPION ROAD, FLOYDS KNOBS, IN 47119
- **Practice address phone:** (812) 786-8751
- **Practice address fax:** (812) 399-3149
- **Mailing address:** 2776 CAMPION RD, FLOYDS KNOBS, IN 47119-8910
- **Mailing address phone:** (812) 786-8751
- **Mailing address fax:** (812) 399-3149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2015
- **Last updated:** 11/05/2015