EAST LOUISVILLE ORAL SURGERY AND DENTAL IMPLANTS PLC NPI 1972782407

NPI Information

EAST LOUISVILLE ORAL SURGERY AND DENTAL IMPLANTS PLC 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. EAST LOUISVILLE ORAL SURGERY AND DENTAL IMPLANTS PLC NPI is 1972782407. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 MIDDLETOWN PARK PL STE A
LOUISVILLE, KY
ZIP 40243-541
Phone: (502) 254-3818
Fax: (502) 254-3819

The provider's authorized official is Kenneth Wayne Livesay .
The authorized official title is Oral Surgeon and has the following contact phone number (502) 254-3818.

The enumeration date for this NPI number is 11/1/2007 and was last updated on 12/12/2019.

Taxonomy Codes

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Other Identifiers

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