| Elm Pediatric Dentistry, Pllc | |
|
6400 Westwind Way Ste C Crestwood KY 40014-6773 | |
| (502) 754-6633 | |
| (859) 207-5102 |
| Full Name | Elm Pediatric Dentistry, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6400 Westwind Way Ste C, Crestwood, Kentucky |
| Authorized Official Name and Position | Austin Rodenberg (DENTIST, OWNER) |
| Authorized Official Contact | 2705729309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elm Pediatric Dentistry, Pllc 934 Woodland Ridge Cir La Grange KY 40031-1373 Ph: (270) 572-9309 | Elm Pediatric Dentistry, Pllc 6400 Westwind Way Ste C Crestwood KY 40014-6773 Ph: (502) 754-6633 |
| NPI Number | 1578255055 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578255055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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