Organization
DHDA HFD, PLLC
Active
Parent organization
DHDA PROVIDERCO, PLLC
Other names
Highland Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHDA PROVIDERCO, PLLC
Authorized official
PAUL T LAVELLE DMD (CLINICAL DIRECTOR)
(203) 921-6141
Entity
Organization
Contact information
Practice address
20 N GRAND AVE STE 10AND11, FORT THOMAS, KY 41075-4106
(203) 921-6141
Mailing address
5404 FARM RIDGE LN, PROSPECT, KY 40059-7617
(203) 921-6141
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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