Organization
OAK TREE DENTAL PLLC
Active
Other names
Revitalize Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA SHAIN (PRACTICE DIRECTOR)
(502) 386-7147
Entity
Organization
Contact information
Practice address
2323 LIME KILN LN, LOUISVILLE, KY 40222-3416
(502) 423-0781
Mailing address
2323 LIME KILN LN, LOUISVILLE, KY 40222-3416
(502) 423-0781
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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