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Organization
MFDC OF INDIANA, INC
Active
Organization
MFDC OF INDIANA, INC
Active
Other names
MFDC of Indiana, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
11801 BRINLEY AVE STE 100, LOUISVILLE, KY 40243-3006
(502) 254-8500
Mailing address
11801 BRINLEY AVE STE 100, LOUISVILLE, KY 40243-3006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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