Organization
JEFFERSONVILLE PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORCHUSA LARAI COMBS DMD, MSD, MS (PEDIATRIC DENTIST)
(502) 994-0389
Entity
Organization
Contact information
Practice address
2929 CHARLESTOWN PIKE, JEFFERSONVILLE, IN 47130-8199
(502) 994-0389
Mailing address
702 PARK CREEK CIR, LOUISVILLE, KY 40245-6241
(502) 994-0389
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/06/2022
Last updated
03/06/2022
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