Organization · Type 2 NPI

Specialized Dental Services-Jefferson Mall, PLLC

Dental Clinic/Center · Louisville, KY

NPI number 1033397914 Active

Practice location

5100 Outer Loop, Suite B
Louisville, KY 40219-4056

Call (502) 410-1702 Map

Mailing address

PO Box 437169
Louisville, KY 40253-7169

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) 1223S0112XNone listed
Anesthesiology Physician 207L00000XNone listed
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

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About NPI 1033397914

Specialized Dental Services-Jefferson Mall, PLLC's National Provider Identifier is 1033397914, issued on Feb 4, 2008. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Louisville, KY. The record was last updated on Aug 2, 2024.