Organization
PERIODONTIC & ENDODONTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (COO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
11708 MAIN ST, MIDDLETOWN, KY 40243-1426
(502) 410-1702
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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