# FAMILY DENTAL ASSOCIATES OF KENTUCKY PSC

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

## Provider details

- **NPI number:** 1528166170
- **Authorized official:** DR. SAMUEL GREGORY BENANTI DMD (OWNER PRES SOLE SHAREHOLDER)
- **Authorized official phone:** (502) 254-8745

## Contact information

- **Practice address:** 8000 WILLIAM G PENNY LANE, LOUISVILLE, KY 40219
- **Practice address phone:** (502) 969-2396
- **Practice address fax:** (502) 969-6901
- **Mailing address:** 802 KINROSS PLACE, LOUISVILLE, KY 40243
- **Mailing address phone:** (502) 254-8745
- **Mailing address fax:** (502) 254-8874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020