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Individual

DR. PAUL THOMAS LAVELLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
13104 US HWY 42, PROSPECT, KY 40059
(502) 228-0234
(502) 228-3127
Mailing address
13104 US HWY 42, PROSPECT, KY 40059
(502) 228-0234
(502) 228-3127

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
4885
KY
1223G0001X
General Practice Dentistry
Primary
4885
KY

Other

Enumeration date
09/12/2006
Last updated
07/23/2012
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