| Green River Oral Surgery | |
|
801 N Elm St Henderson KY 42420-2705 | |
| (270) 212-0330 | |
| (270) 212-0332 |
| Full Name | Green River Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 801 N Elm St, Henderson, Kentucky |
| Authorized Official Name and Position | Robert Gene Wagoner (OWNER) |
| Authorized Official Contact | 5708143085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green River Oral Surgery 801 N Elm St Henderson KY 42420-2705 Ph: (270) 212-0330 | Green River Oral Surgery 801 N Elm St Henderson KY 42420-2705 Ph: (270) 212-0330 |
| NPI Number | 1750638334 |
|---|---|
| Provider Enumeration Date | 08/13/2012 |
| Last Update Date | 08/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750638334 | NPI | - | NPPES |
| 64063514 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 7298 (Kentucky) | Primary |
Henderson Children's Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Barret Blvd Ste A, Henderson, KY 42420 Phone: 270-827-5522 Fax: 270-827-8272 | |
Audubon Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 716 2nd St, Henderson, KY 42420 Phone: 270-826-2092 | |
Edp Of Kentucky Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 342 Starlite Dr, Henderson, KY 42420 Phone: 270-826-1414 | |
Jessica H. Renaker, Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 N Green St, Henderson, KY 42420 Phone: 270-826-7772 | |
Northwest Kentucky Dental Centre Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 Barrett Blvd, Henderson, KY 42420 Phone: 270-827-4534 Fax: 270-827-4503 | |
Audubon Dental Center Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 716 Second Street, Henderson, KY 42420 Phone: 270-826-2092 | |
Brad T Fulkerson, Dmd,msd,llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 700a Barrett Blvd, Henderson, KY 42420 Phone: 270-827-5522 Fax: 270-827-8272 |