Individual
DR. ANN LAKE GREENWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
555 S FLOYD ST, LOUISVILLE, KY 40202-3801
(502) 852-5312
(502) 852-5630
Mailing address
555 S FLOYD ST, LOUISVILLE, KY 40202-3801
(502) 852-5312
(502) 852-5630
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4717
KY
1223P0221X
Pediatric Dentistry
Primary
4717
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60047172
—
KY
Enumeration date
11/19/2005
Last updated
07/15/2009
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