FOURTH ST DENTAL CENTER PSC

LOUISVILLE, KY
NPI1437205556
Entity TypeOrganization
Authorized ContactRODNEY BRENT FULTZ
Sec Treas
502-585-4320
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2007-01-25
Last Update Date2007-12-18
Business Address
FOURTH ST DENTAL CENTER PSC
1018 SOUTH FOURTH STREET
LOUISVILLE, KY 40203
Phone number: 502-585-4320
Mailing Address
FOURTH ST DENTAL CENTER PSC
1018 SOUTH FOURTH STREET
LOUISVILLE, KY 40203
Phone number: 502-585-4320
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