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General NPI Number Information
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NPI Number | 1942740741
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Entity Type | Organization
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Legal Business Name | CROSSINGS CLINIC LOUISVILLE PLLC
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 3935 DUPONT CIR SUITE C
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City | LOUISVILLE
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State | KY
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Zip | 40207-4824
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Country | US
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Telephone | 502-458-7476
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Fax | 502-458-7797
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Provider Business Mailing Address
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Address Line | 5104 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-9429
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Country | US
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Telephone | 812-949-2338
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Fax |
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Authorized Official
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Title or Position | GENERAL MANGER
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Name | MICHAEL ROWE
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Credential |
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Telephone | 812-949-2338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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