| Elm Pediatric Dentistry Of Northern Kentucky Pllc | |
|
1986 Walton Nicholson Pike Independence KY 41051-7906 | |
| (859) 356-5555 | |
| Not Available |
| Full Name | Elm Pediatric Dentistry Of Northern Kentucky Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1986 Walton Nicholson Pike, Independence, Kentucky |
| Authorized Official Name and Position | Austin Rodenberg (OWNER) |
| Authorized Official Contact | 2705729309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elm Pediatric Dentistry Of Northern Kentucky Pllc 934 Woodland Ridge Cir La Grange KY 40031-1373 Ph: (270) 572-9309 | Elm Pediatric Dentistry Of Northern Kentucky Pllc 1986 Walton Nicholson Pike Independence KY 41051-7906 Ph: (859) 356-5555 |
| NPI Number | 1992505739 |
|---|---|
| Provider Enumeration Date | 03/18/2025 |
| Last Update Date | 03/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992505739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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