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Organization

RAKUTT AND PAYNE DENTAL PSC

Active
Other names
Louisville Dental Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANDRA LEIGH PAYNE DMD (OWNER)
(502) 582-2004
Entity
Organization

Contact information

Practice address
801 BARRET AVE, LOUISVILLE, KY 40204-1747
(502) 582-2004
(502) 582-2032
Mailing address
801 BARRET AVE, #107, LOUISVILLE, KY 40204-1747
(502) 582-2004
(502) 582-2032

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60064375
KY
05
60064516
KY
Enumeration date
03/19/2014
Last updated
03/19/2014
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