# A CHOICE DENTAL CARE PLLC

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

## Provider details

- **NPI number:** 1992929954
- **Authorized official:** DR. ROBERT EARL COOPER DMD (CEO)
- **Authorized official phone:** (502) 895-1171

## Contact information

- **Practice address:** 111 FAIRFAX AVE, LOUISVILLE, KY 40207-4905
- **Practice address phone:** (502) 895-1171
- **Practice address fax:** (502) 899-7197
- **Mailing address:** 111 FAIRFAX AVE, LOUISVILLE, KY 40207-4905
- **Mailing address phone:** (502) 895-1171
- **Mailing address fax:** (502) 899-7197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5765 | KY | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 015370 | — | KY |