Organization
ENGILMAN ORTHODONTICS - JEFFERSON
Active
Other names
Braces Braces Braces
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
4801 OUTER LOOP A206, LOUISVILLE, KY 40219-3201
(502) 961-0351
(502) 968-3136
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
(502) 961-0351
(502) 968-3136
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/05/2008
Last updated
06/16/2014
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