# ADVANCED DENTAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADVANCED DENTAL CENTER, INC
- **Other names:** ADVANCED DENTAL CENTER, ADVANCED DENTAL CENTER EAST
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922580653
- **Legal business name:** ADVANCED DENTAL CENTER, INC
- **Authorized official:** DR. RACHEL TALIS DMD (PRESIDENT)
- **Authorized official phone:** (502) 966-4367

## Contact information

- **Practice address:** 1901 RUDY LN STE 4, LOUISVILLE, KY 40207-1384
- **Practice address phone:** (502) 966-4367
- **Mailing address:** 1901 RUDY LN STE 4, LOUISVILLE, KY 40207-1384
- **Mailing address phone:** (502) 966-4367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7118 | KY | Yes |

## Other

- **Enumeration date:** 08/29/2018
- **Last updated:** 06/11/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 61900353 | — | KY |