Organization
ELM PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN RODENBERG DMD (DENTIST, OWNER)
(270) 572-9309
Entity
Organization
Contact information
Practice address
6400 WESTWIND WAY STE C, CRESTWOOD, KY 40014-6773
(502) 754-6633
(859) 207-5102
Mailing address
934 WOODLAND RIDGE CIR, LA GRANGE, KY 40031-1373
(270) 572-9309
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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