Individual
DR. SANDRA L. PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
JOHN P RAKUTT DMD PSC, 801 BARRET AVENUE #107, LOUISVILLE, KY 40204
(502) 582-2004
(502) 582-2032
Mailing address
JOHN P RAKUTT DMD PSC, 801 BARRET AVENUE #107, LOUISVILLE, KY 40204
(502) 582-2004
(502) 582-2032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
KY6437
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004999
DORAL
KY
05
—
60064375
—
KY
Enumeration date
10/03/2006
Last updated
07/08/2007
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