| Engilman Orthodontics - Jefferson | |
|
4801 Outer Loop A206 Louisville KY 40219-3201 | |
| (502) 961-0351 | |
| (502) 968-3136 |
| Full Name | Engilman Orthodontics - Jefferson |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4801 Outer Loop A206, Louisville, Kentucky |
| Authorized Official Name and Position | Stephen James (CFO) |
| Authorized Official Contact | 5022548504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Engilman Orthodontics - Jefferson Po Box 437169 Louisville KY 40253-7169 Ph: (502) 961-0351 | Engilman Orthodontics - Jefferson 4801 Outer Loop A206 Louisville KY 40219-3201 Ph: (502) 961-0351 |
| NPI Number | 1184802860 |
|---|---|
| Provider Enumeration Date | 02/05/2008 |
| Last Update Date | 06/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184802860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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