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Organization
OAK TREE DENTAL PLLC
Active
Organization
OAK TREE DENTAL PLLC
Active
Other names
Revitalize Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA SHAIN (PRACTICE DIRECTOR)
(502) 386-7147
Entity
Organization
Contact information
Practice address
2323 LIME KILN LN, LOUISVILLE, KY 40222-3416
(502) 423-0781
Mailing address
2323 LIME KILN LN, LOUISVILLE, KY 40222-3416
(502) 423-0781
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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