Organization
KIDS DENTISTRY - PROSPECT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
9217 US HIGHWAY 42, PROSPECT, KY 40059-8858
(502) 228-4009
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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