Community Care of Kentucky, INC
NPI #1194103127 in Louisville, Kentucky
Provider Information
- NPI Number
- 1194103127
- Entity Type
- Organization
- Organization Name
- Community Care of Kentucky, INC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COMMUNITY CARE OF KENTUCKY, INC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 11, 2015
- Last Updated
- May 11, 2015
Practice Location
- Address
- 3438 TAYLOR BLVD
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40215-2648
- Phone
- (502) 366-4442
Authorized Official
- Name
- MANDY HOLLAND
- Title
- CREDENTIALING MANAGER
- Phone
- (256) 504-3326
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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