# SMILE ST. MATTHEWS, PLLC

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

## Provider details

- **NPI number:** 1922341254
- **Authorized official:** ANN-MARGARET LUCKETT D.M.D (DENTIST)
- **Authorized official phone:** (502) 593-4116

## Contact information

- **Practice address:** 114 S SHERRIN AVE, LOUISVILLE, KY 40207-3201
- **Practice address phone:** (502) 473-1800
- **Practice address fax:** (502) 409-8525
- **Mailing address:** 114 S SHERRIN AVE, LOUISVILLE, KY 40207-3201
- **Mailing address phone:** (502) 473-1800
- **Mailing address fax:** (502) 409-8525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 8977 | KY | Yes |

## Other

- **Enumeration date:** 04/04/2013
- **Last updated:** 04/04/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100169580 | — | KY |