# DENTAL SERVICES OF LOUISVILLE, PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ImmediaDent
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417125733
- **Authorized official:** RYAN E KLOBOVES DDS (PC PRESIDENT)
- **Authorized official phone:** (502) 452-1886

## Contact information

- **Practice address:** 2245 HIKES LN, LOUISVILLE, KY 40218-2203
- **Practice address phone:** (502) 452-1886
- **Practice address fax:** (502) 452-1955
- **Mailing address:** 2245 HIKES LN, LOUISVILLE, KY 40218-2203
- **Mailing address phone:** (502) 452-1886
- **Mailing address fax:** (502) 452-1955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010746A | IN | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 02/20/2008