Individual
DR. DIMITRIOS SOTIRIOS BASILAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4420 DIXIE HWY STE 110, LOUISVILLE, KY 40216-2986
(502) 447-3323
(913) 752-9116
Mailing address
501 S PRESTON ST, UOFL DEPT. OF SURGICAL AND HOSPITAL DENTISTRY, LOUISVILLE, KY 40202-1701
(502) 852-3534
(502) 852-8551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
9807
KY
1223P0700X
Prosthodontics
Primary
1001997-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2016
Last updated
08/18/2022
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