Provider Demographics
NPI:1497518104
Name:HERITAGE DENTAL CENTER - BUTTERMILK LLC
Entity Type:Organization
Organization Name:HERITAGE DENTAL CENTER - BUTTERMILK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-991-7816
Mailing Address - Street 1:2446 ANDERSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CRESCENT SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2446 ANDERSON RD STE 100
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1400
Practice Address - Country:US
Practice Address - Phone:859-331-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERITAGE DENTAL CENTER, CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental