| Kentucky Oral And Facial Surgery | |
|
3101 Breckenridge Ln Ste 2d Louisville KY 40220-2742 | |
| (502) 459-8012 | |
| Not Available |
| Full Name | Kentucky Oral And Facial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3101 Breckenridge Ln Ste 2d, Louisville, Kentucky |
| Authorized Official Name and Position | Jackie Holloway (DIRECTOR OF RCM) |
| Authorized Official Contact | 8542007970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Oral And Facial Surgery 3700 Ingleside Blvd Ladson SC 29456-4141 Ph: () - | Kentucky Oral And Facial Surgery 3101 Breckenridge Ln Ste 2d Louisville KY 40220-2742 Ph: (502) 459-8012 |
| NPI Number | 1790575736 |
|---|---|
| Provider Enumeration Date | 05/12/2025 |
| Last Update Date | 05/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790575736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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