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General NPI Number Information
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NPI Number | 1295662203
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL CENTER, INC.
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 10519 TAYLORSVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40299-3911
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Country | US
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Telephone | 502-244-7531
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Fax |
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Provider Business Mailing Address
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Address Line | 10519 TAYLORSVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40299-3911
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Country | US
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Telephone | 502-244-7531
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MARK TALIS
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Credential |
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Telephone | 502-966-4367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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