Individual
ANTHONY DISTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2221 MEADOW DR, LOUISVILLE, KY 40218-1330
(502) 523-2433
Mailing address
7907 STONYDALE LN, LOUISVILLE, KY 40220-5037
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9803
KY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/07/2016
Last updated
06/29/2017
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