Individual
DENNIS NORTHENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3563 SPRINGHURST BLVD., LOUISVILLE, KY 40241
(502) 339-7323
(502) 412-7331
Mailing address
3563 SPRINGHURST BLVD., LOUISVILLE, KY 40241
(502) 339-7323
(502) 412-7331
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0821DT
KY
152W00000X
Optometrist
Primary
821DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77008217
—
KY
Enumeration date
12/26/2006
Last updated
07/29/2009
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