Individual
DR. MICHAEL CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M. S.
Contact information
Practice address
644 PHILLIPS LN, SUITE 1002, LOUISVILLE, KY 40209-1312
(502) 375-0095
Mailing address
644 PHILLIPS LN, SUITE 1002, LOUISVILLE, KY 40209-1312
(502) 375-0095
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6725
KY
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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