Organization
TD KY ONE LLC
Active
Other names
Lord Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE NICHOLSON (REGIONAL MANAGER)
(812) 569-2955
Entity
Organization
Contact information
Practice address
3841 RUCKRIEGEL PKWY # 100, LOUISVILLE, KY 40299-3986
(502) 267-4141
Mailing address
3841 RUCKRIEGEL PKWY # 100, LOUISVILLE, KY 40299-3986
(502) 267-4141
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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