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General NPI Number Information
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NPI Number | 1033775374
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Entity Type | Organization
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Legal Business Name | ALEX MAYES YOUNG DMD PLLC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 7400 US 42
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City | FLORENCE
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State | KY
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Zip | 41042-1906
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Country | US
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Telephone | 859-525-2100
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Fax | 502-742-0666
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Provider Business Mailing Address
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Address Line | 516 EASTGATE VILLAGE WYNDE
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City | LOUISVILLE
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State | KY
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Zip | 40223-4781
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Country | US
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Telephone | 502-298-4443
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Fax | 502-742-0666
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDRA MAYES YOUNG
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Credential | DMD
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Telephone | 859-525-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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