Organization
KIDS DENTISTREE OF KY, LLC
Active
Other names
Kids Dentistree of KY, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
11801 BRINLEY AVE STE 100, LOUISVILLE, KY 40243-3006
(502) 254-8500
Mailing address
11801 BRINLEY AVE STE 100, LOUISVILLE, KY 40243-3006
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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