Organization · NPI-2

3rd Street Family Dental

Dentist, General Practice · Louisville, KY

NPI number1124330337
StatusActive
Last updated in NPPESJul 6, 2010

Details

NPI
1124330337
Entity type
Organization (NPI-2)
Legal business name
3rd Street Family Dental
Organization subpart
No
Enumeration date
Jul 6, 2010
Last updated
Jul 6, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes

Practice location

3911 S 3rd St
Louisville, KY 40214-1601

Phone 502-368-5575 · Fax 502-368-5596

Mailing address

3911 S 3rd St
Louisville, KY 40214-1601

Phone 502-368-5575 · Fax 502-368-5596

Authorized official

Kathy Degraaff
President
5023685575

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