Organization
JONATHAN MITCHELL, DMD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN E MITCHELL (OWNER)
(502) 552-8934
Entity
Organization
Contact information
Practice address
1716 GARDINER LN, LOUISVILLE, KY 40205-2738
(502) 552-8934
Mailing address
1716 GARDINER LN, LOUISVILLE, KY 40205-2738
(502) 552-8934
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9250
KY
Other
Enumeration date
07/27/2016
Last updated
09/28/2016
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