| Georgetown Oral And Facial Surgery, Llc | |
|
101 Darby Dr Suite 101 Georgetown KY 40324-8715 | |
| (502) 863-5858 | |
| (859) 971-9722 |
| Full Name | Georgetown Oral And Facial Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 101 Darby Dr, Georgetown, Kentucky |
| Authorized Official Name and Position | Amy Cornette Henderson (OFFICE MANAGER) |
| Authorized Official Contact | 8599719722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgetown Oral And Facial Surgery, Llc 972 Fiddler Creek Way Lexington KY 40515-6460 Ph: (859) 971-9722 | Georgetown Oral And Facial Surgery, Llc 101 Darby Dr Suite 101 Georgetown KY 40324-8715 Ph: (502) 863-5858 |
| NPI Number | 1609000272 |
|---|---|
| Provider Enumeration Date | 05/11/2009 |
| Last Update Date | 06/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609000272 | NPI | - | NPPES |
| 1811915622 | Other | KY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 7379 (Kentucky) | Primary |
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