Organization
COMMUNITY CARE OF KENTUCKY, INC
Active
Parent organization
COMMUNITY CARE OF KENTUCKY, INC
Other names
kentucky05
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CARE OF KENTUCKY, INC
Authorized official
MANDY HOLLAND (CREDENTIALING MANAGER)
(256) 504-3326
Entity
Organization
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) 241-3965
(256) 241-1698
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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