Organization
WHITE LAVENDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH DONLON DMD (FOUNDER)
(502) 805-3074
Entity
Organization
Contact information
Practice address
4122 SHELBYVILLE RD STE A, LOUISVILLE, KY 40207-3212
(502) 805-3074
(502) 251-0922
Mailing address
4122 SHELBYVILLE RD STE A, LOUISVILLE, KY 40207-3212
(502) 805-3074
(502) 251-0922
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
09/25/2025
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