Individual
VITALIA I KADYLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3438 TAYLOR BLVD, LOUISVILLE, KY 40215-2648
(502) 366-4442
(502) 366-4446
Mailing address
PO BOX 2369, ANNISTON, AL 36202-2369
(256) 741-7340
(256) 741-7373
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9135
KY
1223G0001X
General Practice Dentistry
Primary
9135
KY
1223G0001X
General Practice Dentistry
DE60175861
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25281
MCNA
KY
05
—
7100198760
—
KY
Enumeration date
09/08/2010
Last updated
10/18/2016
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