Organization
LIFETIME DENTAL CARE OF KY PSC
Active
Parent organization
LIFETIME DENTAL CARE OF KY PSC
Other names
Crescent Hill Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF KY PSC
Authorized official
KIM ZUBER (INSURANCE / CREDENTIALING)
(217) 540-5100
Entity
Organization
Contact information
Practice address
2416 FRANKFORT AVE STE 3, LOUISVILLE, KY 40206-2571
(502) 893-1990
(502) 893-3690
Mailing address
2416 FRANKFORT AVE STE 3, LOUISVILLE, KY 40206-2571
(502) 893-1990
(502) 893-3690
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7604
KY
Other
Enumeration date
08/17/2009
Last updated
01/16/2017
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