Healthcare Provider Details

I. General information

NPI: 1093787517
Provider Name (Legal Business Name): STEVEN MICHAEL FLORENCE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 11/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 DIXIE HIGHWAY SUITE 104
LOUISVILLE KY
40216
US

IV. Provider business mailing address

5141 DIXIE HIGHWAY SUITE 104
LOUISVILLE KY
40216
US

V. Phone/Fax

Practice location:
  • Phone: 502-448-7988
  • Fax:
Mailing address:
  • Phone: 502-448-7988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number6038
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: