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General NPI Number Information
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NPI Number | 1356130371
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH PEDIATRIC DENTISTRY LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2813 N HURSTBOURNE PKWY STE 106
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City | LOUISVILLE
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State | KY
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Zip | 40223-1281
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Country | US
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Telephone | 502-694-0290
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Fax |
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Provider Business Mailing Address
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Address Line | 2813 N HURSTBOURNE PKWY STE 106
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City | LOUISVILLE
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State | KY
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Zip | 40223-1281
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Country | US
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Telephone | 502-694-0290
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIA DOBSON
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Credential | DMD
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Telephone | 502-694-0290
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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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