Fourth St Dental Center Psc in Louisville - Dental
Fourth St Dental Center Psc - NPI 1437205556
Fourth St Dental Center Psc is a Dental in Louisville, Kentucky. Fourth St Dental Center Psc practices all healthcare services and medical treatments related to Dental. The NPI Number for Fourth St Dental Center Psc is 1437205556. The last update date is 2007-12-18.
Fourth St Dental Center Psc's current location address is 1018 South Fourth Street, Louisville, Kentucky. You can contact this provider via phone number 5025854320. The mailing address for Fourth St Dental Center Psc is 1018 South Fourth Street, Louisville, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Fourth St Dental Center Psc |
|---|---|
| Address | 1018 South Fourth Street, Louisville, Kentucky |
| Phone Number | 5025854320 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SEC TREAS |
|---|---|
| Authorized Official Name | Fultz Brent Rodney |
| Credentials | DMD |
| Telephone Number | 5025854320 |
NPI Number Detail
| NPI Number | 1437205556 |
|---|---|
| Provider Enumeration Date | 2007-01-25 |
| Last Updated Date | 2007-12-18 |
Provider Mailing Address Detail
| Address | 1018 South Fourth Street |
|---|---|
| City | Louisville |
| State | Kentucky (KY) |
| Post Code | 40203 |
| Phone Number | 5025854320 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 61943270 | KY | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Fourth St Dental Center Psc by the Centers for Medicare & Medicaid Services?
The Fourth St Dental Center Psc has been assigned the NPI (National Provider Identifier) 1437205556. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Fourth St Dental Center Psc's facilities are situated?
The facilities of Fourth St Dental Center Psc are physically located at the following address: 1018 South Fourth Street, Louisville, KY, 40203.
What is Fourth St Dental Center Psc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Fourth St Dental Center Psc is Dental, and the corresponding taxonomy classification code for this specialized field is 261Qd0000X.
On what date did Fourth St Dental Center Psc receive its 1437205556 assignment from the Centers for Medicare & Medicaid Services?
The Fourth St Dental Center Psc was assigned its 1437205556 on 2007-01-25, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Fourth St Dental Center Psc last refreshed?
The information related to the Fourth St Dental Center Psc, including its address, specialty, and other relevant details, was last updated on 2007-12-18.
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