| Abcdentistry | |
|
5316 S 3rd St Louisville KY 40214 | |
| (502) 643-0560 | |
| Not Available |
| Full Name | Abcdentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5316 S 3rd St, Louisville, Kentucky |
| Authorized Official Name and Position | Mitisha Martin (OWNER) |
| Authorized Official Contact | 5022768778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abcdentistry 5316 S 3rd St Louisville KY 40214-2612 Ph: (502) 276-8778 | Abcdentistry 5316 S 3rd St Louisville KY 40214 Ph: (502) 643-0560 |
| NPI Number | 1477058659 |
|---|---|
| Provider Enumeration Date | 03/28/2018 |
| Last Update Date | 08/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477058659 | NPI | - | NPPES |
| 7100146420 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8651 (Kentucky) | Secondary |
| 1223G0001X | Dentist - General Practice | 8651 (Kentucky) | Primary |
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