Organization
TDS KY FIVE
Active
Other names
Klein Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE NICHOLSON (REGIONAL MANAGER)
(812) 569-2955
Entity
Organization
Contact information
Practice address
156 THIERMAN LN, LOUISVILLE, KY 40207-5010
(502) 896-2822
Mailing address
156 THIERMAN LN, LOUISVILLE, KY 40207-5010
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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