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General NPI Number Information
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NPI Number | 1508034679
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Entity Type | Organization
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Legal Business Name | DOMENIC M. CALUORI DMD PLLC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 13100 MAGISTERIAL DR
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City | LOUISVILLE
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State | KY
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Zip | 40223-4102
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Country | US
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Telephone | 502-244-4474
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Fax | 309-406-4143
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Provider Business Mailing Address
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Address Line | 13100 MAGISTERIAL DR
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City | LOUISVILLE
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State | KY
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Zip | 40223-4102
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Country | US
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Telephone | 502-244-4474
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Fax | 309-406-4143
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DOMENIC M CALUORI
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Credential | DMD
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Telephone | 502-244-4474
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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 | 7566
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License Number State | KY
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