Old Louisville Dental Centre
NPI #1225640444 in Louisville, Kentucky
Provider Information
- NPI Number
- 1225640444
- Entity Type
- Organization
- Organization Name
- Old Louisville Dental Centre
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 19, 2020
- Last Updated
- Aug 19, 2020
Practice Location
- Address
- 1504 S 7TH ST
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40208-1711
- Phone
- (502) 636-5492
Authorized Official
- Name
- MICHELLE ELIZABETH FAETH
- Title
- OFFICE MANAGER
- Phone
- (502) 718-1226
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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