Organization
ENGILMAN ORTHODONTICS
Active
Other names
Braces Braces Braces
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES (COO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
6408 W HIGHWAY 146, UNIT 10, CRESTWOOD, KY 40014-9575
(502) 241-3176
Mailing address
2005 S HIGHWAY 53, LA GRANGE, KY 40031-9109
(502) 225-0074
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8621
KY
Other
Enumeration date
10/26/2008
Last updated
10/26/2008
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