# CANE RUN SMILE CENTER, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1871647438
- **Authorized official:** DR. SUSIE J. RILEY DMD (OWNER)
- **Authorized official phone:** (502) 448-1003

## Contact information

- **Practice address:** 4516 CANE RUN RD, LOUISVILLE, KY 40216-3422
- **Practice address phone:** (502) 448-1003
- **Practice address fax:** (502) 371-8161
- **Mailing address:** PO BOX 16866, LOUISVILLE, KY 40256-0866
- **Mailing address phone:** (502) 448-1003
- **Mailing address fax:** (502) 371-8161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5214 | KY | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 02/09/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 168937 | MEDICAID SUBCONTRACTOR \# | KY |
| 05 | — | 61942785 | — | KY |