# THE CENTER FOR ADVANCED DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1568557874
- **Authorized official:** RONALD L RECEVEUR DDS (MANAGER MEMBER)
- **Authorized official phone:** (812) 948-2281

## Contact information

- **Practice address:** 819 MOUNT TABOR RD, SUITE 10, NEW ALBANY, IN 47150-6414
- **Practice address phone:** (812) 948-2281
- **Practice address fax:** (812) 945-8374
- **Mailing address:** 819 MOUNT TABOR RD, SUITE 10, NEW ALBANY, IN 47150-6414
- **Mailing address phone:** (812) 948-2281
- **Mailing address fax:** (812) 945-8374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12008027A | IN | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 08/22/2020