# CHILDREN'S SPECIAL CARE DENTISTRY

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

## Provider details

- **NPI number:** 1619151180
- **Authorized official:** SHANNON MARIE ABANG (OFFICE MANAGER)
- **Authorized official phone:** (502) 451-8900

## Contact information

- **Practice address:** 2301 MEADOW DR, LOUISVILLE, KY 40218-1338
- **Practice address phone:** (502) 451-8900
- **Mailing address:** 2301 MEADOW DR, LOUISVILLE, KY 40218-1338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7297 | KY | Yes |

## Other

- **Enumeration date:** 12/19/2007
- **Last updated:** 12/19/2007