Organization
HEART LEAF DENTAL LLC
Active
Other names
Special Care Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL L RUDOLPH DDS (OWNER)
(855) 259-9183
Entity
Organization
Contact information
Practice address
5247 OLD HARDING RD, FRANKLIN, TN 37064-9409
(855) 259-9183
Mailing address
12910 SHELBYVILLE RD STE 300, LOUISVILLE, KY 40243-2404
(855) 259-9183
(502) 254-4077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000002831
TN
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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