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Organization

DENTAL SURGICENTER OF LOUISVILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEVIN LARSEN (CEO)
(717) 489-2198
Entity
Organization

Contact information

Practice address
2800 CANNONS LN STE 100, LOUISVILLE, KY 40205-2173
(502) 813-8604
(502) 813-8612
Mailing address
9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1216
(713) 489-2198
(713) 489-2978

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100510730
KY
Enumeration date
12/06/2017
Last updated
01/30/2026
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