# SHAWNEE DENTAL, PLLC.

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

## Provider details

- **NPI number:** 1316935661
- **Authorized official:** DR. THOMAS E MCLEAN (OWNER)
- **Authorized official phone:** (502) 774-2400

## Contact information

- **Practice address:** 222 AMY AVE, LOUISVILLE, KY 40212-2522
- **Practice address phone:** (502) 774-2400
- **Practice address fax:** (502) 742-3456
- **Mailing address:** 222 AMY AVE, LOUISVILLE, KY 40212-2522
- **Mailing address phone:** (502) 774-2400
- **Mailing address fax:** (502) 742-3456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | KY | Yes |

## Other

- **Enumeration date:** 10/11/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 61943148 | — | KY |