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General NPI Number Information
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NPI Number | 1033347869
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Entity Type | Organization
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Legal Business Name | ENGILMAN ORTHODONTICS-SHEPHERDSVILLE, PLLC
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 1746 HIGHWAY 44 E
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-6131
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Country | US
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Telephone | 502-531-9339
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 437169
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City | LOUISVILLE
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State | KY
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Zip | 40253-7169
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STEVE JAMES
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Credential |
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Telephone | 502-254-8504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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