Organization
KENTUCKIANA DENTAL GROUP
Active
Other names
Crossings Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SHELLENBERGER (OFFICE MANAGER)
(502) 938-9056
Entity
Organization
Contact information
Practice address
321 W BRUCE ST STE 300, SEYMOUR, IN 47274-2319
(812) 523-1860
Mailing address
PO BOX 305, SEYMOUR, IN 47274-0305
(812) 523-1860
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011969
IN
Other
Enumeration date
05/18/2016
Last updated
11/23/2016
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