Pediatric Dentistry of Oldham Countyq

NPI #1033555982 in La Grange, Kentucky

Provider Information

NPI Number: 1033555982
Entity Type: Organization
Organization Name: Pediatric Dentistry of Oldham Countyq
Primary Specialty: Dentist
Enumeration Date: May 20, 2013
Last Updated: May 20, 2013

Practice Location

Address: 1000 BUCKNER CTR
Address 2: SUITE 3
City: La Grange
State: Kentucky
ZIP Code: 40031-7790
Phone: (502) 222-8848

Authorized Official

Name: DR. TRACY LEANN KIM, DMD,MBA
Title: DENTISTR/OWNER
Phone: (502) 222-8848

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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