Organization
LOUISVILLE DENTAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY EAVES (ACCOUNTING/OFFICE MANAGER)
(601) 575-8806
Entity
Organization
Contact information
Practice address
16701 E MAIN ST, LOUISVILLE, MS 39339-2751
(601) 575-8806
Mailing address
186 FAULK RD, EUPORA, MS 39744-5580
(662) 552-6407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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