Organization
ADVANCED DENTAL CENTER BROOKS
Active
Parent organization
ADVANCED DENTAL CENTER, INC
Other names
Advanced Dental Center Brooks
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED DENTAL CENTER, INC
Authorized official
DR. RACHEL TALIS DMD (PRESIDENT)
(502) 966-4367
Entity
Organization
Contact information
Practice address
1064 BROOKS HILL RD, BROOKS, KY 40109-5149
(502) 955-1084
Mailing address
8517 PRESTON HWY, LOUISVILLE, KY 40219-5301
(502) 966-4367
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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