Organization
CHILDREN'S SPECIAL CARE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARIE ABANG (OFFICE MANAGER)
(502) 451-8900
Entity
Organization
Contact information
Practice address
2301 MEADOW DR, LOUISVILLE, KY 40218-1338
(502) 451-8900
Mailing address
2301 MEADOW DR, LOUISVILLE, KY 40218-1338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7297
KY
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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