Organization
D & D DENTAL ENTERPRISES
Active
Parent organization
KENTUCKIANA DENTAL GROUP
Other names
Spring Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKIANA DENTAL GROUP
Authorized official
ADRIENNE NICHOLSON (OFFICE MANAGER)
(812) 569-2955
Entity
Organization
Contact information
Practice address
6790 DIXIE HWY, LOUISVILLE, KY 40258
(502) 935-1414
Mailing address
321 W BRUCE ST, SEYMOUR, IN 47274-2319
(812) 523-1860
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81190630
DENTAL
—
Enumeration date
06/20/2018
Last updated
06/20/2018
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