Organization
DENTAL SERVICES OF KENTUCKY, PSC
Active
Parent organization
DENTAL SERVICES OF KENTUCKY, PSC
Other names
ImmediaDent
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL SERVICES OF KENTUCKY, PSC
Authorized official
MONICA L LONG (MANAGER OF CREDENTIALING)
(913) 428-1686
Entity
Organization
Contact information
Practice address
2011 GRINSTEAD DR UNIT 102, LOUISVILLE, KY 40204-1296
(502) 638-2377
(913) 752-9116
Mailing address
PO BOX 11568, OVERLAND PARK, KS 66207-4268
(913) 428-1686
(913) 752-9116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
11/16/2017
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