KENTUCKIANA ORAL & MAXILLOFACIAL SURGERY ASSOC PSC NPI 1396737011

NPI Information

KENTUCKIANA ORAL & MAXILLOFACIAL SURGERY ASSOC PSC is an oral and maxillofacial surgery dentist in Louisville, KY. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. KENTUCKIANA ORAL & MAXILLOFACIAL SURGERY ASSOC PSC NPI is 1396737011. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2800 CANNONS LN
STE 200
LOUISVILLE, KY
ZIP 40205
Phone: (502) 454-4885
Fax: (502) 452-1926

The provider's authorized official is Nathan F Walters .
The authorized official title is President and has the following contact phone number (502) 454-4885.

The enumeration date for this NPI number is 8/18/2005 and was last updated on 2/6/2018.

Taxonomy Codes

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Other Identifiers

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