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Organization

TRIPLE CROWN DENTISTRY

Active
Parent organization
TRIPLE CROWN DENTISTRY
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRIPLE CROWN DENTISTRY
Authorized official
DR. MARY SHIELDS D.M.D. (OWNER)
(502) 409-4299
Entity
Organization

Contact information

Practice address
904 LILY CREEK ROAD, SUITE 101, LOUISVILLE, KY 40243
(502) 409-4299
(502) 409-4309
Mailing address
904 LILY CREEK ROAD, SUITE 101, LOUISVILLE, KY 40243
(502) 409-4299
(502) 409-4309

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9076
KY
1223G0001X
General Practice Dentistry
9305
KY

Other

Enumeration date
06/15/2017
Last updated
06/15/2017
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