PORTLAND DENTAL PSC

LOUISVILLE, KY
NPI1528118601
Entity TypeOrganization
Authorized ContactRODNEY BRENT FULTZ
Sec Treas
502-778-7678
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center Dental
Enumeration Date2007-01-11
Last Update Date2007-12-18
Business Address
PORTLAND DENTAL PSC
465 NORTH 26TH STREET
LOUISVILLE, KY 40212
Phone number: 502-778-7678
Mailing Address
PORTLAND DENTAL PSC
465 NORTH 26TH STREET
LOUISVILLE, KY 40212
Phone number: 502-778-7678
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