Organization · Type 2 NPI

Kids Dentistry-Jefferson Mall,pllc

Dental Clinic/Center · Louisville, KY

NPI number 1639357502 Active

Practice location

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

Call (502) 969-9266 Map

Fax (502) 254-6054

Mailing address

PO Box 437169
Louisville, KY 40253-7169

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

11 other providers at this address

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About NPI 1639357502

Kids Dentistry-Jefferson Mall,pllc's National Provider Identifier is 1639357502, 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 Jan 19, 2011.