Provider Demographics
NPI:1457364374
Name:FOOTE & FOOTE, P.S.C.
Entity Type:Organization
Organization Name:FOOTE & FOOTE, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FOOTE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-896-8669
Mailing Address - Street 1:4213 N CHURCH WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3926
Mailing Address - Country:US
Mailing Address - Phone:502-896-8669
Mailing Address - Fax:
Practice Address - Street 1:4213 N CHURCH WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3926
Practice Address - Country:US
Practice Address - Phone:502-896-8669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty