Healthcare Provider Details

I. General information

NPI: 1780345512
Provider Name (Legal Business Name): ASB DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 NEW LA GRANGE RD STE 115
LOUISVILLE KY
40222-4871
US

IV. Provider business mailing address

7410 NEW LA GRANGE RD STE 115
LOUISVILLE KY
40222-4871
US

V. Phone/Fax

Practice location:
  • Phone: 502-425-6515
  • Fax: 502-425-9246
Mailing address:
  • Phone: 502-425-6515
  • Fax: 502-425-9246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW STEPHEN BECHT
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 502-425-6515