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General NPI Number Information
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NPI Number | 1215193974
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Entity Type | Organization
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Legal Business Name | JOSEPH H. CIESLAK, DDS, PLLC
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 5906 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40291-1935
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Country | US
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Telephone | 502-231-2230
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Fax | 502-231-3443
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Provider Business Mailing Address
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Address Line | 5906 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40291-1935
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Country | US
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Telephone | 502-231-2230
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Fax | 502-231-3443
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH H CIESLAK
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Credential | DDS
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Telephone | 502-231-2230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 7038
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 7038
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License Number State |
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