Organization
THE CENTER FOR ADVANCED DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD L RECEVEUR DDS (MANAGER MEMBER)
(812) 948-2281
Entity
Organization
Contact information
Practice address
819 MOUNT TABOR RD, SUITE 10, NEW ALBANY, IN 47150-6414
(812) 948-2281
(812) 945-8374
Mailing address
819 MOUNT TABOR RD, SUITE 10, NEW ALBANY, IN 47150-6414
(812) 948-2281
(812) 945-8374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008027A
IN
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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