Organization
KIDS DENTISTRY-LAGRANGE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETPHEN JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
2005 S HIGHWAY 53, SUITE D, LA GRANGE, KY 40031-9109
(502) 225-6820
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2012
Last updated
01/20/2012
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