PEDIATRIC DENTAL GROUP OF LOUISVILLE NPI 1942329495

NPI Information

PEDIATRIC DENTAL GROUP OF LOUISVILLE is a pediatric dentistry dentist in Louisville, KY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDIATRIC DENTAL GROUP OF LOUISVILLE NPI is 1942329495. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9710 PARK PLAZA AVE
SUITE 101
LOUISVILLE, KY
ZIP 40241-291
Phone: (502) 327-6380
Fax: (502) 327-8650

The provider's authorized official is Connie Ison .
The authorized official title is Business Manager and has the following contact phone number (502) 327-6380.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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