Organization
LIFETIME DENTAL CARE OF KY PSC
Active
Parent organization
LIFETIME DENTAL CARE OF KY PSC
Other names
St. Mathews Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF KY PSC
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
100 MARSHALL DR, LOUISVILLE, KY 40207-3459
(502) 897-3424
(502) 894-0342
Mailing address
100 MARSHALL DR, LOUISVILLE, KY 40207-3459
(502) 897-3424
(502) 894-0342
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/21/2006
Last updated
12/20/2024
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