Organization
ADVANCED DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHEL TALIS D.M.D. (OWNER)
(502) 966-4367
Entity
Organization
Contact information
Practice address
8517 PRESTON HWY, LOUISVILLE, KY 40219-5301
(502) 966-4367
(502) 966-4001
Mailing address
8517 PRESTON HWY, LOUISVILLE, KY 40219-5301
(502) 966-4367
(502) 966-4001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477904498
NPI
KY
05
—
60071180
—
KY
05
—
7100317780
—
KY
Enumeration date
11/14/2006
Last updated
09/12/2016
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