Organization
MAGNOLIA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E CROWL DDS (PRESIDENT)
(502) 709-9430
Entity
Organization
Contact information
Practice address
3801 S HURSTBOURNE PKWY, LOUISVILLE, KY 40299-7319
(502) 709-9430
Mailing address
3801 S HURSTBOURNE PKWY, LOUISVILLE, KY 40299-7319
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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