Market St Dental Office Psc

LBN: Market St Dental Office Psc
Market St Dental Office Psc is an health care organization with primary practice located at 2410 West Market St , Louisville KY 40212. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Market St Dental Office Psc can be contacted via phone (502) 778-5141, or through Fultz, Rodney Brent via phone (502) 778-5141.

Contact Information

Primary practice address
2410 West Market St Louisville KY 40212
Phone: (502) 778-5141
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fultz, Rodney Brent Doctor of Dental Medicine (DMD)
Phone: (502) 778-5141

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1477605426
LBN Legal business name Market St Dental Office Psc
DBA Doing business as
Authorized official Fultz, Rodney Brent Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 18th, 2007
Last updated Dec 18th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477605426 NPPES
Kentucky MEDICAID 61942983

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