Organization
KIDS DENTISTRY-JEFFERSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
2917 E 10TH ST, 105, JEFFERSONVILLE, IN 47130-6916
(812) 284-2103
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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