Greenwell, Ann Lake

Greenwell, Ann Lake is an individual health care provider with primary practice located at 555 S Floyd St , Louisville KY 40202-3801. She recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / Dentist. Dental Providers / Pediatric Dentistry is her primary health care specialty. Greenwell, Ann Lake can be contacted via phone (502) 852-5312.

Contact Information

Primary practice address
555 S Floyd St Louisville KY 40202-3801
Phone: (502) 852-5312
Fax: (502) 852-5630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 4717 Kentucky
Dental Providers / Dentist 122300000X 4717 Kentucky

Profile Details

NPI number 1912989302
LBN Legal business name Greenwell, Ann Lake
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2005
Last updated Jul 15th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912989302 NPPES
Kentucky MEDICAID 60047172

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