# BRECKENRIDGE DENTAL, PSC

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

## Provider details

- **NPI number:** 1396545083
- **Authorized official:** JEFF KING DMD (OWNER)
- **Authorized official phone:** (502) 451-5222

## Contact information

- **Practice address:** 3348 HIKES LN STE 107, LOUISVILLE, KY 40220-2000
- **Practice address phone:** (502) 451-5222
- **Practice address fax:** (502) 451-5263
- **Mailing address:** 3348 HIKES LN STE 107, LOUISVILLE, KY 40220-2000
- **Mailing address phone:** (502) 451-5222
- **Mailing address fax:** (502) 451-5263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 03/13/2025
- **Last updated:** 03/18/2025