Ray, Keith Leslie
Ray, Keith Leslie is an sole proprietor health care provider with primary practice located at 5713 Bardstown Rd , Louisville KY 40291-1913. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Ray, Keith Leslie can be contacted via phone (502) 231-1418.Contact Information
Primary practice address
5713 Bardstown Rd
Louisville KY 40291-1913
Phone: (502) 231-1418
Fax: (502) 231-0051
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 5018 | Kentucky |
Profile Details
| NPI number | 1902896814 |
|---|---|
| LBN Legal business name | Ray, Keith Leslie |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Jan 4th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902896814 | NPPES |
| Kentucky | MEDICAID | 60050184 |
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